Key result
Profound asymptomatic sinus bradycardia (33 bpm) in a 54-year-old female endurance athlete with severe anorexia nervosa presented a complex clinical scenario for pacemaker implantation.
Why the study?
Profound asymptomatic sinus bradycardia in the 20-30 beats per minute range is underdocumented in the literature and uncommon, presenting difficult pacemaker implantation decisions in frail patients with anorexia nervosa and endurance training.
Case Report (n=1)
Profound asymptomatic sinus bradycardia can occur in patients with severe anorexia nervosa and endurance training, requiring careful consideration before pacemaker implantation to avoid further physical and psychological repercussions.
Profound asymptomatic bradycardia can occur with severe AN plus endurance training; leaves open optimal management including device therapy.
We present a case of a 54-year-old woman with asymptomatic bradycardia who was referred for consideration of a pacemaker for profound chronic sinus bradycardia (heart rate is 33 beats per minute). Further, history and physical revealed a self-described endurance athlete with severe anorexia nervosa (AN). Background. Anorexia nervosa and endurance training are known contributors to bradycardia; however, profound asymptomatic sinus bradycardia in the 20-30 beats per minute is underdocumented in the literature and not a common presentation in any setting. The decision to implant a permanent pacemaker could potentially lead to further physical and psychological repercussions in such a frail patient.
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Pueringer et al. (2022) conducted a case report in Profound chronic sinus bradycardia and severe anorexia nervosa (n=1). Severe anorexia nervosa and endurance training was evaluated. Profound asymptomatic sinus bradycardia (33 bpm) in a 54-year-old female endurance athlete with severe anorexia nervosa presented a complex clinical scenario for pacemaker implantation.
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