Dual chamber pacemaker implantation has been investigated as a possible treatment modality for patients with advanced congestive heart failure (CHF) who do not respond to current pharmacologic approaches. By optimizing atrioventricular contraction with pacing, hemodynamics have been shown to improve in short-term studies. The long-term benefits of therapy have not been demonstrated conclusively, and clinical trials are now in progress to study pacemaker implantation with and without implantable cardioverter defibrillators as a possible therapeutic option.