YOUNG AT A SLOW PACE!

Abstract

Bradycardia is defined as a Heart Rate (HR) of less than 60 beats per minute (bpm). In most young people, bradycardia is sinus and corresponds to a physiological response. A young woman, 22 years old, with no relevant personal history, a father with an acute myocardial infarction at age 40, maternal uncle with sudden death at age 50, seeks consultation with her attending physician because she has low HR without associated symptoms. On physical examination, the patient’s heart rate was 45 bpm, with no other significant alterations. A requested ECG detected: “Sinus rhythm, with periods of Atrioventricular Block (AVB) 2:1 and complete AVB. Average HR 46 bpm”. In view of the findings, the patient was referred to the cardiology emergency department of the reference hospital, having been hospitalized for study. On the date of discharge, the patient was referred to an arrhythmology consultation, having undergone cardiac magnetic resonance imaging and a genetic study which did not reveal any significant alterations. Due to her age and lack of symptoms, it wasn’t easy to make a therapeutic decision. As a result of the potential iatrogenic risk and morbidity associated with cardiac devices at such a young age, clinical and electrocardiographic surveillance was chosen.