In the past, permanent pacing was indicated only in patients with severe, life-threatening bradycardia. Currently, we take the indication for permanent pacing into account not only the need to ensure an adequate heart rate, but also the hemodynamic effects of stimulation, its aim is not only to rescue, but also improve the quality of life. Cardiac resynchronization therapy in the last decade in developed countries has become a very important therapeutic modality for advanced heart failure inadequately responsive or resistant to pharmacotherapy. Cardiac resynchronization therapy helps to restore atrioventicular, inter- and intra-ventricular synchrony, improving left ventricle function, reducing functional mitral regurgitation and inducing left ventricle reverse remodelling. Currently, the indications for permanent pacing and resynchronization therapy guided by the ESC Guidelines on cardiac pacing and cardiac resynchronization therapy from 2013.