Congestive heart failure (CHF) is a common, debilitating and usually lethal condition responsible for enormous burden on health care. The recent trials have shown improvement in morbidity and mortality with ACE inhibitors and beta blockers1,2,3. However, despite this the overall prognosis remains dismal. The other alternative of cardiac transplantation has several limitations including the donor organ scarcity. In view of this gloomy prognosis, several alternative strategies are being explored, one of which has been pacing for heart failure. In this form of therapy pacing is used in absence of the conventional bradyarrhthymic indications with an attempt to lead to optimization of AV delay and co-ordination of ventricular contraction.