Abstract
A 66 years old man was admitted because of chest pain and syncope. Echocardiogram showed a marked pressure gradient across the left ventricular (LV) outflow tract and LV hypertrophy. On 23 rd day, severe chest pain occurred, which was followed by cardiogenic shock. Because of cardiac arrest, temporary pacing is performed, Dual-chamber (DDD) pacing with pacing rate 80 bpm and atrio-ventricular (AV) delay 100 msec markedly reduced the pressure gradient of LV outflow tract from 94mmHg to 11mmHg. Follow up cardiac catheterization 5 months after showed that the pressure gradient remained abolished even when pacing was switched off. DDD pacing has been reported as a beneficial method for hypertrophic obstructive cardiomyopathy.