Swallowing induced supraventricular tachycardia in a neonate

Deglutition induced atrial tachycardia and atrial fibrillation

Deglutition induced supraventricular tachycardia is an uncommon condition postulated to be a vagally mediated phenomenon due to mechanical stimulation. Patients usually present with mild symptoms or may have severe debilitating symptoms. Treatment with Class I agents, beta blockers, calcium channel blockers, amiodarone and radiofrquency catheter ablation has shown to be successful in the majority of reported cases. We report the case of a 46-year-old healthy woman presenting with palpitations on swallowing that was documented to be transient atrial tachycardia with aberrant ventricular conduction as well as transient atrial fibrillation. She was successfully treated with propafenone with no induction of swallowing-induced tachycardia after treatment. This is also the first case to show swallowing-induced atrial tachycardia and atrial fibrillation in the same patient.

Radiofrequency ablation of swallowing-induced atrial tachycardia: case report and review of literature

We report the case of a 47-year-old white man who presented with 1-year history of palpitations while swallowing. Event monitor confirmed the episodes were atrial tachycardia. Medical management with a calcium channel blocker did not alleviate the patient's symptoms. Gastrointestinal endoscopy did not reveal any abnormality. Electrophysiologic study was performed to identify and map the tachycardia. Swallowing during the procedure was used to repeatedly induce the tachycardia. A focal right atrial tachycardia that was mapped to the lower posterior right atrium was successfully ablated. Follow-up at 6 months and 1 year showed complete resolution of symptoms. An in-depth review of the literature and all published case reports of swallowing-induced atrial tachycardia is presented, and possible mechanisms of this rare form of tachycardia are discussed.