Systemic light chain cardiac amyloidosis with atrioventricular block

This case highlights a crucial principle in the management of AL amyloidosis: improvement in hematologic status and cardiac structure/function does not equate to electrophysiologic stability. In high-risk patients, vigilance for occult conduction disease must persist even after clinical recovery. The ICM serves as a pivotal "bridge" tool to detect intermittent, life-threatening bradyarrhythmias and guide timely, precise device-based intervention. These findings underscore the need for individualized, long-term cardiac electrophysiological monitoring strategies in patients with AL-CA.