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.