Bradycardia can induce increased serum natriuretic peptide-level

Here we report a case of an elderly woman whose antihypertensive beta-blocker therapy induced sinus arrest with a 40 bpm junctional escape rhythm. Although there was no sign of heart failure during bradycardia, a highly elevated amino-terminal pro-brain natriuretic peptide (NT-proBNP) serum level was detected. Cessation of the beta-blocker agent resulted in normal sinus rhythm and a rapid fall in the NT-proBNP serum level. As a rare phenomenon, bradycardia-related cardiomyopathy is discussed.