Mahmoodi Ehsan, Denman Russell A, Walters Darren L
Department of Cardiology, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, Queensland 4032, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland 4072, Australia.
Eur Heart J Case Rep. 2025 Apr 26;9(6):ytaf212. doi: 10.1093/ehjcr/ytaf212. eCollection 2025 Jun.
Bariatric surgery has been shown to improve long-term cardiovascular outcomes in patients with morbid obesity. However, there is limited data on cardiac arrhythmias occurring after bariatric surgery. We report a case of recurrent syncope due to high-grade atrioventricular block (AVB) after gastric sleeve surgery.
A 32-year-old woman with a background of morbid obesity and diet-controlled type 2 diabetes mellitus, presented with recurrent post-prandial syncope two months after gastric sleeve surgery. Her 12 lead ECG (electrocardiogram) showed sinus rhythm with non-specific T wave inversion in lead III, and her blood tests including serum electrolytes, thyroid function, and autoimmune screening were all within normal limits. Transthoracic echocardiogram demonstrated a structurally normal heart; however, a 24-h Holter monitor revealed episodes of high-grade AVB, corresponding with post-prandial syncopal episodes. Considering her history of recurrent syncope due to post-prandial high-grade AVB, without any reversible causes, she underwent a dual-chamber permanent pacemaker implantation. At 3 months clinic follow-up she had not experienced any recurrence of syncope.
Weight loss after bariatric surgery is associated with improved long-term cardiovascular outcomes. However, available data suggests a relationship between bariatric surgery and cardiac bradyarrhythmias. In our case, we report recurrent episodes of syncope due to high-grade AVB after gastric sleeve surgery, treated by permanent pacemaker implantation. To our knowledge, this complication has not been previously reported, and this case highlights the need for further studies to explore the relationship between bariatric surgery and cardiac arrhythmias and to prevent potential complications.
减重手术已被证明可改善病态肥胖患者的长期心血管结局。然而，关于减重手术后发生心律失常的数据有限。我们报告一例胃袖状切除术后因高度房室传导阻滞（AVB）导致反复晕厥的病例。
一名32岁女性，有病态肥胖病史且为饮食控制的2型糖尿病患者，在胃袖状切除术后两个月出现反复餐后晕厥。她的12导联心电图（ECG）显示窦性心律，III导联有非特异性T波倒置，其血液检查包括血清电解质、甲状腺功能和自身免疫筛查均在正常范围内。经胸超声心动图显示心脏结构正常；然而，24小时动态心电图监测发现有高度AVB发作，与餐后晕厥发作相对应。考虑到她因餐后高度AVB导致反复晕厥的病史，且无任何可逆性病因，她接受了双腔永久起搏器植入术。在3个月的门诊随访中，她未再出现晕厥复发。
减重手术后体重减轻与改善长期心血管结局相关。然而，现有数据表明减重手术与心脏缓慢性心律失常之间存在关联。在我们的病例中，我们报告了胃袖状切除术后因高度AVB导致反复晕厥发作，通过永久起搏器植入进行治疗。据我们所知，此前尚未报道过这种并发症，该病例凸显了需要进一步研究以探讨减重手术与心律失常之间的关系并预防潜在并发症。
