Conclusion
Severe hypertension often improves following treatment of bradycardia but this phenomenon is under-reported. In this case, bradycardia as a result of CHB occurred in the context of a hypertensive emergency refractory to multiple medical therapies. BP was only controlled following permanent pacing with an immediate rise in diastolic BP likely related to a faster HR. A reduction in diastolic filling time and SV may have contributed to better control of systolic BP, although other factors such as pacing-induced dyssynchrony and SVR could have also played a role. Pacing may therefore benefit patients early in their clinical course.