Key result
Dual-chamber pacing resolves postprandial high-grade AV block and syncope following gastric sleeve surgery.
Why the study?
Bariatric surgery improves long-term cardiovascular outcomes in morbid obesity, but data on cardiac arrhythmias occurring after bariatric surgery are limited.
Case Report (n=1)
This case highlights a potential novel complication of high-grade atrioventricular block and recurrent syncope following gastric sleeve surgery, which was successfully treated with a permanent pacemaker.
May indicate rare post-bariatric high-grade AV block; single case leaves open causality and incidence.
Background: 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. Case summary: 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. Discussion: 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.
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Mahmoodi et al. (2025) conducted a case report in High-grade atrioventricular block and recurrent syncope (n=1). Gastric sleeve surgery was evaluated on Recurrence of syncope. Gastric sleeve surgery was associated with the development of post-prandial high-grade atrioventricular block and recurrent syncope in a 32-year-old woman, which was successfully treated with a dual-chamber permanent pacemaker.
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