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Profound bradycardia associated with NIV removal

Profound bradycardia associated with NIV removal,10.1016/j.rmedc.2011.07.006,Respiratory Medicine Cme,C. Echevarria,S. C. Bourke,G. J. Gibson

Profound bradycardia associated with NIV removal  
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A patient with lower-limb onset ALS presented with a one-month history of vasovagal episodes and a one-week history of cough productive of green sputum and lethargy. She was drowsy and in acute on chronic type-two respiratory failure. She responded to non-invasive ventilation, however she suffered recurrent episodes of profound bradycardia on removal of the mask, which gradually resolved over ten days. We have reviewed the literature and offer a potential explanation for these events.
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