A 48-Year-Old Athletic Man With Bradycardia During Sleep

Abstract

A 48-year-old athletic man with history of dyslipidemia and seconddegree atrioventricular block (Mobitz type I 2:1 atrioventricular block) endorses sleeprelated difficulties at his annual physical examination. Mobitz type I block was diagnosed 11 years earlier when the patient presented to his primary care physician with left-sided chest pain for 2 months. He was evaluated by cardiology, with a normal stress echocardiogram. The impression was that the chest pain was nonanginal. He describes sleeping for only a few hours at a time and has nighttime awakenings. He does not wake up feeling refreshed. He experiences passive daytime sleepiness and evening somnolence. He is very active, runs every day, and has participated in several half-marathons. He currently undergoes high-intensity interval training, including running and lifting. Per his wife, the patient snores loudly and has apneic episodes during sleep. One of his siblings has OSA. He denies excessive sleepiness, with an Epworth Sleepiness Scale score of 2.

Amateur Athlete with Sinus Arrest and Severe Bradycardia Diagnosed through a Heart Rate Monitor: A Six-Year Observation—The Necessity of Shared Decision-Making in Heart Rhythm Therapy Management

“…It is possible that the athlete developed an abnormal “regulatory” response to physical activity, for which there is no clear evidence. An important fact is the absence of concomitant diseases in the described athlete, which could be responsible for bradyarrhythmia, unlike other publications [ 47 ].…”