POSTPRANDIAL ATRIOVENTRICULAR-BLOCK IN A PATIENT WITH DIABETES-MELLITUS

Postprandial atrioventricular (AV) block and hypotension occurred in a n 80-year-old man with a 13-year history of diabetes mellitus. Two wee ks before admission, he experienced syncope on two occasions after lun ch. Master's two-step test induced second degree AV block (2:1 block). Four days after admission, syncope recurred while walking 1 hour afte r eating; electrocardiogram (ECG) showed complete AV block following 2 :1 block. PP interval analysis suggested phase 3 block as the mechanis m of AV block. Electrophysiologic study revealed 2:1 HV block. Postpra ndial syncope ceased after permanent pacemaker implantation. Postprand ial AV block and hypotension merit close attention in diabetics.