Mrudula Tatakuri, Vikranth Mummaneni, Rajesh Kota, Uma Surapaneni, Vijay Koduru
Laparoscopic-assisted surgeries in a patient with second-degree heart block have an exponential risk of progression to complete heart block. The prognosis of a patient with AV node (nodal block) is usually benign and block distal to AV node (intranodal block) has a potentially high risk of progression to complete heart block. Insertion of a pacemaker preoperatively remains a tricky situation even in distal AV node block. At our institute, a 75-yearold male patient with a second-degree Atrio Ventricular (AV) block with left bundle branch block was scheduled to undergo laparoscopic-assisted anterior perineal resection without prior pacemaker insertion. So, in this case, in the report, we would discuss how a case of second-degree AV block with bundle branch block was managed safely under general anaesthesia without prior pacemaker insertion