85 y/o F with PMHx of HTN, HL, h/o breast CA and 3cm renal pelvis transitional cell tumor who presented for nephrectomy.  Her post op course was complicated by agitation thought due to narcotics.  Today, she was restarted on her home meds and while on telemetry, pt was noted to be bradycardic to 40s.  Pt was triggered for SBP of 70 and HR of 40 during which she remained asymptomatic.  She was given 1L IVF and her HR/BP trended back up to baseline.  However, there was a second event an hour later when she sat up and became bradycardic in the 30s with associated hypotension. Second episode occurred with position change and again, pt developped junctional rhythm in 30s.