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Severe Sinus Node Dysfunction in Obstructive Jaundice

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▸Requests for reprints should be addressed to Tali Bashour, M.D.; The San Francisco Heart Institute, 1900 Sullivan Avenue; Daly City, CA 94015.

Seton Medical Center, Daly City; and the University of California School of Medicine, San Francisco, California

Ann Intern Med. 1985;103(3):384-385. doi:10.7326/0003-4819-103-3-384
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Sinus bradycardia has been linked to obstructive jaundice, among other metabolic, systemic, and central nervous conditions (1, 2). Conclusive evidence of sinus node dysfunction in association with biliary obstruction has not to our knowledge been presented. We report the case of a patient with gall bladder and bile duct malignancy who, as obstruction progressed, had cardiac arrest in asystole. He later had prolonged episodes of sinus pause complicated by escape atrial, junctional, or ventricular arrythmias. These arrythmias have disappeared and a markedly prolonged sinus node recovery time returned to normal after reduction of bilirubin levels by drainage of the bile


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Severe sinus node dysfunction in obstructive jaundice. Ann Intern Med 1985;103(3):384-5.
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