Successful treatment of severe orthostatic hypotension with cardiac tachypacing in dual chamber pacemakers

Orthostatic hypotension is an evolving and disabling disease usually observ ed ed in elderly patients with dramatic consequences on morbidity, mortalit y and impairing the quality of life. We studied the effects of the pacing r ate and AV interval on the blood pressure drop in the upright position in t wo patients with previously implanted pacemakers for sinus node dysfunction . Although the AV interval did not affect the blood pressure drop in the up right position, tachypacing at 100 paces/min improved it dramatically and p revented syncope. Cardiac tachypacing is a useful therapeutic option in sev ere refractory orthostatic hypotensive patients, especially those with chro notropic incompetence.