The treatment of obstructive hypertrophic cardiomyopathy is classically based on beta blockers, cardiac calcium channel blockers or amiodarone to improve the symptoms and to decrease the intraventricular gradient. However, this treatment may prove to be insufficient or poorly tolerated. Two chamber cardiac pacing no constitutes an alternative to surgical treatment, as it improves the symptoms and decreases the left intraventricular gradient, by modifying the ventricular activation sequence. In order to be effective, ventricular pacing must be continuous, with a sufficiently short atrioventricular period to allow continuous ventricular preexcitation, while preserving atrial contraction. However, it has yet to be demonstrated that continuous ventricular pacing provides a survival benefit for these patients.