Peram L, Ramcharan P, Maharaj M, Katwaroo A, Battersby S, Seecheran V, Seecheran R, Seecheran N. Transient Supine-Induced Advanced Heart Block in an Octogenarian.
J Investig Med High Impact Case Rep 2025;
13:23247096251345375. [PMID:
40448521 DOI:
10.1177/23247096251345375]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2025] Open
Abstract
Atrioventricular block (AVB) is a conduction disorder that can lead to significant bradyarrhythmias with resultant hemodynamic compromise and cardiogenic shock. While most cases of positional AVB that occur during erect posture are attributed to neurocardiogenic mechanisms, complete AVB occurring exclusively in the supine position is an exceedingly rare phenomenon. We present a case of an 87-year-old Caribbean Black male who presented with symptomatic supine-induced advanced heart block, which transiently resolved during standing with unremarkable comprehensive investigations and subsequently underwent successful dual-chamber permanent pacemaker implantation. The clinician should be cognizant of assessing positional vital signs with telemetric monitoring in patients presenting with idiopathic bradyarrhythmias and presyncope.
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