Introduction

Endomyocardial fibrosis (EMF) is characterized by fibrous tissue deposition on endocardial surfaces leading to impaired filling of one or both ventricles, resulting in either right or left heart failure or both1. Chronic heart failure, thromboembolic disease and arrhythmia are some of the associated complications. Incidence of complete heart block (CHB) necessitating a pacemaker is rare in EMF1. We report two cases in which the patients had EMF with CHB, who were treated with an alternative pacing strategy.