Deglutition Induced Atrial Tachycardia and Atrial Fibrillation

Abstract

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.

Transient swallowing‐induced atrial tachycardia in a patient with genotyped hypertrophic cardiomyopathy

“…Although it is rare, numerous cases have been reported worldwide. [1][2][3][4][5][6][7][8] The events that provoke this transient supraventricular tachyarrhythmia include swallowing, coughing, and mechanical stimulation of the esophagus. [1][2][3][4][5][6][7][8] In most cases, the tachycardia is self-limiting with spontaneous termination within a few seconds of onset.…”

“…1 SIAT was first reported in 1926 2 and is defined as tachyarrhythmia that occurs reproducibly and consistently during a swallow. [1][2][3][4][5][6][7][8] Tachyarrhythmias induced by a swallow include premature atrial contraction, atrial tachycardia, and atrial fibrillation. Although patients with SIAT develop palpitations triggered by deglutition, most cases are not associated with structural heart disease, and successful treatment of SIAT with radiofrequency catheter ablation (RFCA) or pharmacological drugs has been described.…”

“…Although patients with SIAT develop palpitations triggered by deglutition, most cases are not associated with structural heart disease, and successful treatment of SIAT with radiofrequency catheter ablation (RFCA) or pharmacological drugs has been described. [1][2][3][4][5][6][7] A recent report described an adolescent patient with hypertrophic cardiomyopathy (HCM) who developed SIAT and was treated by RFCA. 8 We herein report a case of SIAT in a patient with HCM caused by p.Phe244Leu in the cardiac beta-myosin heavy chain gene (MYH7).…”

Swallowing-induced atrial tachycardia

“…Again, this nonuniform atrial depolarization can result in focal reentry, leading to atrial arrhythmias. 6,7…”

To the Editor—Swallowing-induced atrial tachycardia arising from superior vena cava: significant involvement of parasympathetic nerve activity

“…Several case reports in the literature address effective pharmacologic therapy of swallowing-induced arrhythmias with remissions lasting even after its termination 2, 3, 4. Therefore, we would like to stress that in similar cases treatment should be principally focused on antiarrhythmic drugs with known vagolytic action, since spontaneous remissions are possible and catheter ablation is an invasive procedure with few, but potentially serious, complications.…”