4. Dual-Chamber Pacemaker
Dual-chamber pacemaker insertion is based on the obser¬vation that excitation of the septum by pacing causes the septum to contract away from the opposing wall reducing the obstruction to outflow of blood from the ventricle (reduces the left ventricular outflow tract gradient). This strategy appeared useful in the European trial, but several trials in the United States have failed to show significant benefit.

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