Though numerous reports suggest that about one third of patients with congestive heart failure (CHF) have preserved left ventricular systolic function, in the absence of any large-scale clinical trial targeting these patients, the optimal treatment of diastolic heart failure remains unknown. Patients with CHF attributable to diastolic dysfunction form an extremely heterogeneous group and, in the majority of cases, once pericardial disease and restrictive and hypertrophic cardiomyopathies have been excluded, no specific disease sustaining diastolic dysfunction can be evidenced. Accordingly, the management of such patients consists of general measures such as vigorous blood pressure control, relief of myocardial ischemia, maintenance of sinus rhythm, and prevention of an elevated heart rate. This article discusses the scarce published experience of the use of drugs and cardiac electrical stimulation in heart failure with diastolic dysfunction...