title: Sleep apnea and severe bradyarrhythmia--an alternative treatment option: a case report.
abstract: BACKGROUND
  Sinus arrest, atrio-ventricular block, supraventricular, and ventricular arrhythmias have been reported in patients with sleep apnea syndrome. The arrhythmias usually occur during sleep and contribute to the cardiovascular morbidity and mortality, and the treatment of sleep apnea usually results in the resolution of the brady- arrhythmias. Weight loss, continuous positive airway pressure (CPAP), oral appliances, and upper airway surgery are the recommended treatments, however, compliance and efficacy are issues.
  
  
  METHODS
  A 58-year-old Arab man presented with recurrent presyncope. He was subsequently diagnosed with sleep apnea associated with frequent and significant sinus pauses. He presented a treatment challenge because he refused continuous positive airway pressure and pacemaker, however, he was successfully treated with theophylline.
  
  
  CONCLUSIONS
  Frequent and significant sinus pause associated with sleep apnea was successfully treated with theophylline in our patient when the standard treatment of care was refused.
authors.affiliation: Section of Adult Cardiology, Cardiovascular Department, King Faisal Specialist Hospital & Research Center, P.O. Box 40047, Jeddah, 21499, Kingdom of Saudi Arabia. amindaoulah@yahoo.com.
authors.forename: Amin
authors.initials: A
authors.lastname: Daoulah
authors.affiliation: Internal Medicine Department, University of Alabama Huntsville Regional Medical Campus, Huntsville, Alabama, USA. dr.sara.ocheltree@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Ocheltree
authors.affiliation: Section of Pulmonology, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia. salemalfaifi@hotmail.com.
authors.forename: Salem M
authors.initials: SM
authors.lastname: Al-Faifi
authors.affiliation: Section of Infectious Disease, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia. waleedamasaib@hotmail.com.
authors.forename: Waleed
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. alsheikhali@gmail.com.|Department of Medicine, Tufts University School of Medicine, Boston, MA, USA. alsheikhali@gmail.com.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.affiliation: Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. farhan.asrar@medportal.ca.|Health & Counselling Centre, University of Toronto, Mississauga, Ontario, Canada. farhan.asrar@medportal.ca.
authors.forename: Farhan
authors.initials: F
authors.lastname: Asrar
authors.affiliation: Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA. amir.lotfi@tufts.edu.
authors.forename: Amir
authors.initials: A
authors.lastname: Lotfi
mesh_terms: D001919:Bradycardia / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000188:drug therapy*; D013806:Theophylline / Q000627:therapeutic use; D016312:Treatment Refusal
chemical_list: D013806:Theophylline