Intermittent AV block conduction abnormalities in the setting of acute pancreatitis

A 56-year-old Caucasian male was admitted to our hospital with complaints of shortness of breath, joint aches, and chills in the absence of fever. During his hospitalization, he remained afebrile, but developed multiple episodes of bradycardia and intermittent second degree atrioventricular (AV) block, with both Wenckebach and Mobitz type II episodes. Laboratory evaluation demonstrated a chronically elevated amylase, without any significant electrolyte abnormalities. Abdominal computed tomography scan revealed prominence of the pancreatic head without any discrete pancreatic mass, suggestive of chronic pancreatitis. Pancreatic disorders, including acute pancreatitis or exacerbation of chronic pancreatitis, may be associated with intermittent transient AV block conduction abnormalities. Although the pathophysiology remains unclear, awareness of this entity is important for clinicians for appropriate management. Progression to more severe, permanent AV block necessitating permanent pacemaker implant to our knowledge has not been reported.