Spontaneous, sustained low frequency oscillations of pulmonary arterial pressure were observed in 8 patients with moderate to severe chronic heart failure during recordings of pulmonary arterial pressure of 8.6 to 48 hours duration. The oscillations (frequency range 0.015 to 0.035 Hz) had a distinct peak from and lower frequency range than respiration (0.2 to 0.6 Hz) and heart rate (0.8 to 1.9 Hz). They were present from 42% to 82% of the recording time with an amplitude varying from undetectable to a maximum range from 5.3 mm Hg to 19.7 mm Hg. When detectable, the mean amplitude of the low frequency oscillations of pulmonary arterial pressure ranged from 1.2 +/- 1.2(SD) mm Hg to 4.3 +/- 3.3 mm Hg. These oscillations are lower in frequency than the low frequency component usually described in recordings of systemic arterial pressure and heart rate in normal subjects, and are closer to the very low frequency rhythms described in severe chronic heart failure and Cheyne Stokes respiration.