Work

Post-prandial high-grade atrioventricular block after gastric sleeve surgery: a case report

Year: 2025

Type: article

Abstract: Background: Bariatric surgery has been shown to improve long-term cardiovascular outcomes in patients with morbid obesity. However, there is limited data on cardiac arrhythmias occurring after bariatric surgery. We report a case of recurrent syncope due to high-grade atrioventricular block (AVB) after gastric sleeve surgery. Case summary: A 32-year-old woman with a background of morbid obesity and diet-controlled type 2 diabetes mellitus, presented with recurrent post-prandial syncope two months after gastric sleeve surgery. Her 12 lead ECG (electrocardiogram) showed sinus rhythm with non-specific T wave inversion in lead III, and her blood tests including serum electrolytes, thyroid function, and autoimmune screening were all within normal limits. Transthoracic echocardiogram demonstrated a structurally normal heart; however, a 24-h Holter monitor revealed episodes of high-grade AVB, corresponding with post-prandial syncopal episodes. Considering her history of recurrent syncope due to post-prandial high-grade AVB, without any reversible causes, she underwent a dual-chamber permanent pacemaker implantation. At 3 months clinic follow-up she had not experienced any recurrence of syncope. Discussion: Weight loss after bariatric surgery is associated with improved long-term cardiovascular outcomes. However, available data suggests a relationship between bariatric surgery and cardiac bradyarrhythmias. In our case, we report recurrent episodes of syncope due to high-grade AVB after gastric sleeve surgery, treated by permanent pacemaker implantation. To our knowledge, this complication has not been previously reported, and this case highlights the need for further studies to explore the relationship between bariatric surgery and cardiac arrhythmias and to prevent potential complications.

Source: European Heart Journal - Case Reports

DOI: 10.1093/ehjcr/ytaf212

Authors: Ehsan Mahmoodi, Russell A Denman, Darren L Walters

Institutions: The University of Queensland, Prince Charles Hospital

Language: English

Topic: Bariatric Surgery and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $815