[Advanced auriculoventricular block of atypical presentation after acute myocardial infarct in sleep apnea syndrome]. / Bloqueo auriculoventricular avanzado de presentación atípica tras infarto agudo de miocardio en el síndrome de apnea del sueño.

We report a case of an adult male in whom, one week after an anterior acute myocardial infarction, we documented nocturnal episodes of type II second degree atrio-ventricular heart block, including advanced heart block episodes (4:1). An electrophysiologic study did not show atrio-ventricular conduction abnormalities, so we suspected a possible sleep apnea syndrome, which was confirmed with a polysomnographic study. It was observed that advanced heart block episodes were preceded by significant decreases in arterial oxygen saturation. These episodes disappeared with continuous positive air pressure ventilation.