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REM sleep-related bradyarrhythmia syndrome
Karolina Perez1, Misty Shah1, Aadhavi Sridharan1
1The University of Arizona College of Medicine - Tucson, Tucson, Arizona.
Summary
Rapid eye movement sleep-related bradyarrhythmia syndrome causes dangerous heart pauses during sleep. This case highlights a young male with prolonged sinus pauses, managed non-invasively.
Area of Science:
- Cardiology
- Sleep Medicine
- Neurology
Background:
- Rapid eye movement (REM) sleep-related bradyarrhythmia syndrome is a rare condition.
- It involves sinus arrest or atrioventricular conduction blocks during REM sleep, independent of sleep-disordered breathing.
Observation:
- A young male patient presented with symptoms suggestive of obstructive sleep apnea.
- Polysomnography revealed significant sinus pauses (up to 9.7 seconds) during REM sleep.
- Extended monitoring showed numerous prolonged pauses (longest 12.5 seconds) during nocturnal hours.
Findings:
- The patient exhibited significant bradyarrhythmia exclusively during REM sleep.
- Despite prolonged pauses and a low heart rate (14 bpm), the patient was asymptomatic between events.
- A conservative management approach was chosen over pacemaker implantation.
Implications:
- This case underscores the importance of considering REM sleep-related bradyarrhythmia syndrome in patients with unexplained nocturnal bradycardia.
- Non-invasive monitoring and shared decision-making are crucial for managing this rare condition.
- Further research is needed to understand the pathophysiology and optimal treatment strategies.
Keywords:
REM sleepREM sleep-related brady arrhythmia syndromeatrioventricular blockbradyarrhythmiasinus arrestMore Related Videos
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