Work

REM Sleep–Associated Asystole

Year: 2026

Type: article

Abstract: BACKGROUND: Rapid eye movement (REM) sleep-associated bradyarrhythmia syndrome is characterized by asystole or complete heart block during the REM phases of sleep. There are minimal reported cases in the literature. CASE SUMMARY: This is a case of REM-associated sinus pauses incidentally noted on a sleep study in a young, healthy patient. Despite an implantable loop recorder demonstrating continued nocturnal pauses of up to 9.5 seconds, the patient remained without daytime symptoms or pauses and was managed without a pacemaker. DISCUSSION: REM sleep-associated bradyarrhythmia syndrome is a rarely described and poorly understood phenomenon with minimal guidelines for management. It may be underreported given that it is often asymptomatic and incidentally noted on sleep studies. Close surveillance may be appropriate rather than pacemaker implantation in those patients who are without daytime symptoms.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.106924

Authors: Jessica Huang, Kristi Pangborn, Christopher Suhar, Ulrika Birgersdotter-Green, Nicholas Olson, Douglas Gibson

Institutions: Scripps Health, Scripps Clinic, University of California San Diego

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: gold

Estimated APC paid: $850