Symptomatic, Inspiration-Induced Atrioventricular Block: Treated with Pacemaker Implant

Area of Science:

• Cardiology
• Autonomic Nervous System Physiology

Background:

• Respiratory sinus arrhythmia (RSA) is a common, normal variation in heart rate tied to breathing.
• It involves increased heart rate during inspiration and decreased rate during expiration due to autonomic nervous system activity.
• RSA is typically observed in younger individuals but can occur at any age.

Observation:

• A 46-year-old female presented with dizziness and loss of balance.
• These symptoms were specifically reported during deep inspiration.

Findings:

• The patient exhibited sinus bradycardia (slow heart rate) and atrioventricular block.
• These cardiac events were associated with her deep inspiration episodes.

Implications:

• This case suggests that respiratory sinus arrhythmia can manifest with significant symptoms in adults.
• Unusual presentations of RSA, including bradycardia and heart block, warrant further investigation.
• Understanding the link between breathing and cardiac function is crucial for diagnosing and managing such conditions.