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Angiology
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Correction of AV-Nodal Block in a 27-Year-old Man with Severe Obstructive Sleep Apnea

A Case Report

Louis Voigt, MD

New York Methodist Hospital, Brooklyn, NY, and Columbia University College of Physicians and Surgeons, New York, NY.

Barry I. Saul, MD, FACC, FACA

New York Methodist Hospital, Brooklyn, NY, and Columbia University College of Physicians and Surgeons, New York, NY.

Gerard Lombardo, MD, FACP

New York Methodist Hospital, Brooklyn, NY, and Columbia University College of Physicians and Surgeons, New York, NY.

C.V.R. Reddy, MD, FACC

New York Methodist Hospital, Brooklyn, NY, and Columbia University College of Physicians and Surgeons, New York, NY.

John Kassotis, MD, Eng Sci D, FACC

Columbia University College of Physicians and Surgeons, New York, NY.

A 27-year-old morbidly obese man diagnosed with severe obstructive sleep apnea (OSA) and experiencing significant ventricular asystoles at times exceeding 8 seconds, during polysomnography. The bradyarrhythmias were successfully corrected with the application of a nasal continuous positive airway pressure (CPAP) mask. Follow-up 24-hour ambulatory Holter monitoring without the aid of a nasal CPAP mask and repeat polysomnography with a CPAP mask after several weeks of continuous CPAP therapy during sleep revealed no evidence of ventricular asystole, despite no change in the patient's body mass index. We discuss several mechanisms explaining the findings in this particular patient.

Angiology, Vol. 54, No. 3, 363-367 (2003)
DOI: 10.1177/000331970305400314
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