Conservative Management of Reversible Total Atrioventricular Block Resulting in Sinus Rhythm Recovery: A Case Report

Eka Oktaviana Hirda (Emergency Department, Fatimah Islamic Hospital, Banyuwangi, Indonesia)
Nelly Mulyaningsih (Cardiovascular Department, Fatimah Islamic Hospital, Banyuwangi, Indonesia)
Mohammad Sutami (Anesthesiology and Intensive Care Department, Syaiful Anwar Hospital, Malang, Indonesia)
Athaya Rahmanardi Muhammad (Faculty of Medicine, Brawijaya University, Malang, Indonesia)

Jurnal Ilmu Kedokteran dan Kesehatan
Vol 13, No 6 (2026): Volume 13 Nomor 6

A 49-year-old woman presented with weakness, nausea, and vomiting and was found to have complete atrioventricular (AV) block on electrocardiography. Initial evaluation suggested hypovolemia and electrolyte disturbance due to poor oral intake, with mild hypokalemia identified as a potential reversible contributor to the conduction abnormality. Although temporary pacing was considered because of the severity of the AV block, the patient was managed conservatively with fluid resuscitation and potassium replacement after referral was declined by the family. Progressive clinical and electrocardiographic improvement was observed, with restoration of normal sinus rhythm by the sixth hospital day and complete resolution of symptoms. This case highlights the importance of identifying reversible causes before permanent pacemaker implantation.