Greetings. Welcome to HCM and thank you for your question. I carefully read your query. Pacemaker is a device that work by sending electrical stimuli to the heart muscles to contract. The natural pacemaker of the heart is the sinus. Due to various heart conditions or other conditions, and due to natural scarring of this tissues, that happens due to ageing, the sinus node can become insufficient and produce various electrical and conduction disturbances in the heart. It is then when a outer source of generating heart stimuli is indicated to be implanted. This is the pacemaker implantation. Basically, due to insufficient sinus node, the pacemaker works that way that will not let the heart stop, literally. If your cardiologist decided to recommend for its placement, then there is a clear indication for this action. In our clinic s experience, it was implanted to a woman of 106 years old three years ago, whom I met casually about two months ago and she was doing really fine. If we are talking about pacemaker implantation in a heart failure condition, then we are probably talking about a biventricular pacemaker, which is the cardiac resynchronization therapy (CRT), then it is a pacemaker recommended to ameliorate the heart function and synchronize both ventricles to contract simultaneously. Whichever the recommendation of your cardiologist, I think it is done based on some tests you have run. I hope I was helpful with my answer. Best regards. Dr. Meriton