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The aim of this case report is to present a case of a 24-year old male patient with known cholelithiasis who was presented to the emergency department with acute calculous cholecystitis. The patient was initially in sinus rhythm, but during observation converted into a complete heart block. A temporary heart pacemaker was inserted prior to an emergency laparoscopic cholecystectomy. Postoperatively, the patient converted back to sinus rhythm and made a complete recovery. Considering the patient’s age, normal cardiac workup and that his arrhythmia disappeared after the removal of his gallbladder, it was postulated that this patient had a case of cardio-biliary reflex. Special attention must be given to patients with acute cholecystitis and electrocardiographic changes. Acute cholecystitis is a treatable cause of a newly diagnosed atrioventricular block, thus immediate cholecystectomy should not be deferred.

Intermittent Complete Heart Block in Acute Calculous Cholecystitis