Abstract
Fixed rate single and paired pulse stimulation has been compared in the normal dog left ventricle and in the left ventricle failing after myocardial damage. In the normal heart a persistent positive inotropic effect occurred, seen mainly as an increase in rate of rise of left ventricular pressure, rather than total work. In the failing heart there was a transient positive inotropic effect, followed by increasing ventricular failure. The increasing failure was reversed by a return to single pulse stimulation.