Curative Therapy for Swallowing‐Induced Tachycardia by Pulmonary Vein Antrum Isolation

Abstract

We present a case of a 49-year-old man who experienced invariably reproducible paroxysmal supraventricular tachycardia during swallowing. Because beta-blockers and multiple antiarrhythmic drugs failed to prevent the episodes of this tachycardia, we performed catheter mapping and ablation. After placing multiple decapolar catheters, when the patient swallowed a few sections of an orange, intracardiac mapping revealed atrial premature beats and atrial tachycardia that lasted for a few seconds and arose from an ostial site of the right superior pulmonary vein. After the right superior pulmonary vein antrum was completely isolated, the patient became free from the swallowing-induced tachycardia.

Non‐Contact Three‐Dimensional Mapping and Ablation of Swallowing‐Induced Atrial Tachyarrhythmias: Two Case Reports

“…There have been only four cases, including our two cases, in which RF catheter ablation was attempted as a cure, and all resulted in a successful ablation. 3,4 No recurrence of the tachycardia occurred in any of the patients. Therefore, RF ablation of the ectopic focus may offer an attractive and possibly permanent solution to conditions of this kind.…”

Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity

“…They also described that the most possible mechanism was a vagally mediated neural reflex involving a neurotransmitter other than acetylcholine because atropine and bethanechol did not affect the swallowing-induced AT. Recently, many other reports suggested a neural reflex as the cause of swallowing-induced AT 8, 9, 10, 11…”

Speech‐Induced Atrial Tachycardia: An Unusual Presentation of Supraventricular Tachycardia

“…2,3 Several reports have described that heart rate variability is linked with swallowing, speech changes, and breath holding. [3][4][5][6][7][8][9][10][11] However, no strong correlation has been reported between voice and arrhythmia induction and maintenance. There are scant reports of tachyarrhythmias associated with speech, both published in abstract form.…”