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Heart block in patients after bariatric surgery accompanying sleep apnea
M Block1, L B Jacobson, R A Rabkin
1Departments of Medicine and Surgery, California Pacific Medical Center, San Francisco, CA, USA. mattblock@hotmail.com
Background:
Heart block and bradycardia during sleep has been reported in patients with obesity. The occurrence of bradyarrhythmias in patients after undergoing bariatric surgery has not been reported.
Methods:
Over a period of 6 months, 3 patients who underwent laparoscopic weight reduction surgery developed prolonged heart block during sleep. Clinical course and follow-up are presented.
Results:
All 3 patients were diagnosed with sleep apnea. For 2 of these patients this was a new diagnosis. The episodes of heart block coincided with their episodes of sleep apnea. During follow-up of at least 6 months, no patient has had any adverse consequences related to their nocturnal heart block.
Conclusion:
Heart block during sleep is sometimes seen in patients undergoing bariatric surgery. The cause is sleep apnea, which often is worsened in the postoperative state due to narcotic analgesics. These patients require treatment of their sleep apnea, not pacemakers.