ABSTRACT
Definitive cardiac stimulation ralatually used for brady cardia are going to be in the third millennium the specific therapy of arythmia and cardiomyopathy. In the last 10 years, may progress occur in the use of cardiac stmulation as hemodynamic therapy of obstructures hypertrophic and dialted cardiomyobathies resistant to conventional medical treatment. Moreover auricular stimulation present antiarythmic effects in somme atrial arythmias as auricular fibrillations auricular diseases and atypical flutters. It confirmed by prospective multicentric randomized trials cardiac stimulation may represent in the future a good physiopathologic and efficient treatment free from the sidee effects of drugs that remain partially active. These perspectives needs to be modulated by the known and acceptable resks of a definitive cardiac stimulation