title: Profound bradycardia associated with NIV removal.
abstract: 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.
authors.affiliation: North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Echevarria
authors.affiliation: North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, United Kingdom.
authors.forename: S C
authors.initials: SC
authors.lastname: Bourke
authors.affiliation: Newcastle University, Tyne And Wear, NE2 4HH, United Kingdom.
authors.forename: G J
authors.initials: GJ
authors.lastname: Gibson
keywords: Amyotrophic lateral sclerosis; Bradycardia; Hypercapnia; Motor Neurone Disease; Non-invasive ventilation; Respiratory failure