NPPB and Heart block: Orsbourn et al. also reported on the use of dual-chamber pacing in seven of the 23 patients they studied.42 Lepillier et al. followed eight patients with complete heart block and heart failure who had temporary dual-chamber pacemakers placed and observed an improvement in heart failure symptoms and brain natriuretic peptide levels.40 Level of activity was reported in 10 studies (Table 4).