Work

Transient Complete Atrioventricular Block During Routine Colonoscopy: A Benign Vagal Reflex Mimicking Conduction System Disease

Year: 2025

Type: article

Abstract: Complete heart block during gastrointestinal procedures is rare but clinically significant. These episodes are most commonly mediated by excessive vagal stimulation induced by sedation or endoscopic manipulation, and they typically resolve spontaneously without the need for emergent intervention. We report the case of a 68-year-old woman who developed transient complete heart block during routine colonoscopy and upper endoscopy performed under anesthesia. Her rhythm normalized without pharmacologic therapy or pacing. This case underscores the importance of recognizing vagally mediated atrioventricular (AV) block in procedural settings, as misinterpretation of these transient events may lead to unnecessary evaluations or inappropriate permanent pacemaker implantation. Increased awareness of this benign, reflex-mediated phenomenon may help clinicians avoid overdiagnosis of intrinsic conduction disease.

Source: Cureus

DOI: 10.7759/cureus.99741

Authors: Sebastian Hernandez Mejia, Joud Fahed, Rayna Isber, Nidal Isber

Institutions: Richmond University Medical Center, Saint Agnes Hospital, Columbia University, Barnard College

Language: English

Topic: Cardiac electrophysiology and arrhythmias

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4417530226