Background: Normal orthostatic response enables the human being to preserve his blood pressure and organ perfusion with the change in posture. The maintenance of this mechanism is very important for the comfort of the daily life. AIM OF WORK: The study aimed to illustrate the orthostatic response of a patient with implanted anti-bradycardia pacing devices compared to normal subjects, aiming at better selection of pacing modality in deferent patient profiles. Patients and Methods: This study was carried out in Pacemaker Follow-up Clinic, Cardiac Electrophysiology Unit, Cardiology Department, Zagazig University, from February 2019 to August 2019. The study included 81 patients with pacemaker implantation [48 with Single ventricular pacing ventricular sensing inhibition (VVI), and 33 with Dual chamber pacing Dual sensing (DDD) pacemakers], and 20 apparently healthy controls. Results : In the VVI group the heart rate didn’t change during the recording period and in the pre-tilt period the heart rate behavior of DDD and control group was the same with no statistically significant difference between the two groups. In the post-tilt period there was a significant increase in heart rate in both groups in nearly the same pattern with no statistically significant difference. In both groups the heart rate didn’t drop to the pre-tilt levels until the end of the recording. Conclusion: Pacing especially VVI mode induce blunting in orthostatic systolic blood pressure response which can be a drawback of pacing. Although a patient with DDD had a much better response than VVI patient.