Abstract
Non Invasive Ventilation (NIV) is frequently used in Obstructive Airway Disease (OAD) especially COPD (Chronic Obstructive Pulmonary Disease). Patients often get hypoxic or retain carbon dioxide during attempts to feed the patient orally or trial of intermittent support. However, patient developing sudden bradycardia by mere taking off the mask and reverting to sinus rhythm as soon as mask is put back is extremely rare. We present one such case that was also a treatment challenge for us. Recurrent bradycardia in COPD, with repeatability on discontinuation of Non Invasive Ventilation (NIV) is an extremely rare condition with not much reports/studies in the medical literature. The mechanisms leading to such an event are poorly understood. To the best of our knowledge, it's the first case to be reported from India.