To pace or not to pace, that’s (still) the question, from heart to … brain

Heart and brain have similarities, both can be paced and shocked. Cardiac pacemaker and defibrillator allowed, according to the locations of the pacing and defibrillating lead(s), to pace respectively with low or high energies different cardiac topographic regions in order to monitor, treat heart’s arrythmias and try to restore the more physiologic cardiac functioning. The technical transposition of cardiac pacing to the brain might be the deep brain stimulation (DBS) for invasive technics avec repetitive transmagnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for non-invasive technics. Similarly, the electroconvulsive therapy (ECT) is an equivalent for brain to cardiac defibrillator (i.e. external one). The transposition from heart to brain and then from heart's device to brain's device let us to imagine the long path to attain. rTMS, tDCS, DBS’s or ECT algorithms suffer from a lack of complexity. Only deaf devices exist. A better understanding of the heart and the brain is therefore still and always more necessary. Therefore, connections are always more than necessary in all disciplines including medical, as illustrated by the heart and the brain. Cardiac modulation might show the path to neuro modulation. Theses latter have results, but the available treatments give mitigate responders and are too approximative in comparison to the wider complexity of the organs and to unknown feedbacks so far. Are we then clear enough in our way of defining the mental pathologies, sometimes so nosographycally different but with such common semiological specificities?