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Case report
Bradyarrhythmia secondary to vagus nerve stimulator 7 years after placement
  1. Haresh Gandhi1,
  2. Michelina Ippoliti1,
  3. Farrukh Iqbal1 and
  4. Ajay Shah2
  1. 1Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
  2. 2Cardiology, Monmouth Medical Center, Long Branch, New Jersey, USA
  1. Correspondence to Dr Haresh Gandhi;{at}


We present a case of a 38-year-old man with a previous medical history of asthma and refractory epilepsy requiring vagal nerve stimulator (VNS) placement 7 years prior to the presentation who was found to be in atrial fibrillation with a rapid ventricular response during a preoperative evaluation, which prompted transoesophageal echocardiography and subsequent cardioversion. In preparation for cardioversion, the VNS was turned off and the patient was cardioverted to normal sinus rhythm. Following cardioversion, the VNS was activated again. During recovery, the patient was experiencing several episodes of first-degree and second-degree Mobitz type-II atrioventricular (AV) block. In response, the VNS was deactivated indefinitely. On interrogation of a loop recorder 2 weeks after discharge, the patient did not have any further evidence of AV conduction delay.

  • arrhythmias
  • cardiovascular medicine

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  • Contributors HG, MI, FI and AS provided and cared for study patient. HG and MI worked on writing the manuscript and outlining the framework. FI worked on history and physical examination portion of manuscript and getting patient consent. AS served as scientific advisor and supervisor for the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.