{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:23Z","timestamp":1756425863728,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,9]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2020-235514","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T15:57:33Z","timestamp":1593532653000},"page":"e235514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Bradyarrhythmia secondary to vagus nerve stimulator 7 years after placement"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1835-2202","authenticated-orcid":false,"given":"Haresh","family":"Gandhi","sequence":"first","affiliation":[{"name":"Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelina","family":"Ippoliti","sequence":"additional","affiliation":[{"name":"Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farrukh","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiology, Monmouth Medical Center, Long Branch, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"2025082804254187000_13.6.e235514.1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3889\/oamjms.2017.056","article-title":"Vagus nerve stimulation","volume":"5","author":"Ekmek\u00e7i","year":"2017","journal-title":"Open Access Maced J Med Sci"},{"key":"2025082804254187000_13.6.e235514.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2004.05.008"},{"key":"2025082804254187000_13.6.e235514.3","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/MJT.0b013e31828df0c7","article-title":"Late-onset advanced heart block due to vagal nerve stimulation","volume":"21","author":"Schevchuck","year":"2014","journal-title":"Am J Ther"},{"key":"2025082804254187000_13.6.e235514.4","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/j.1528-1167.2007.01023.x","article-title":"Late onset bradyarrhythmia during vagus nerve stimulation","volume":"48","author":"Amark","year":"2007","journal-title":"Epilepsia"},{"key":"2025082804254187000_13.6.e235514.5","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/j.1528-1167.2008.01918.x","article-title":"Late-onset periodic asystolia during vagus nerve stimulation","volume":"50","author":"Iriarte","year":"2009","journal-title":"Epilepsia"},{"key":"2025082804254187000_13.6.e235514.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2015.01.006"},{"key":"2025082804254187000_13.6.e235514.7","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.seizure.2016.11.018","article-title":"Cardiovascular autonomic and hemodynamic responses to vagus nerve stimulation in drug-resistant epilepsy","volume":"45","author":"Garamendi","year":"2017","journal-title":"Seizure"},{"key":"2025082804254187000_13.6.e235514.8","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1016\/j.hrthm.2014.05.020","article-title":"Pacemaker implantation for treatment of symptomatic atrioventricular conduction block caused by a vagus nerve stimulator","volume":"11","author":"Yun","year":"2014","journal-title":"Heart Rhythm"},{"key":"2025082804254187000_13.6.e235514.9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.pediatrneurol.2017.11.014","article-title":"Complete atrioventricular heart block from an epilepsy treatment","volume":"80","author":"Brinkley","year":"2018","journal-title":"Pediatr Neurol"},{"key":"2025082804254187000_13.6.e235514.10","unstructured":"Schachter SC . Vagus nerve stimulation therapy for the treatment of epilepsy. UpToDate. Available: https:\/\/www.uptodate.com\/contents\/vagus-nerve-stimulation-therapy-for-the-treatment-of-epilepsy [Accessed 10 Oct 2019]."},{"key":"2025082804254187000_13.6.e235514.11","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ebcr.2018.04.004","article-title":"New onset syncopal events following vagus nerve stimulator implantation might be key to preventing vagus nerve stimulation-induced symptomatic bradycardia - A case report and review","volume":"10","author":"Kato","year":"2018","journal-title":"Epilepsy Behav Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-235514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:26:43Z","timestamp":1756380403000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-235514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":11,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,30]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/bcr-2020-235514"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-235514","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}