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

Abstract

A 63-year-old male radio announcer was admitted with a narrow complex, long RP tachycardia. While in the awake state, the patient spoke in his radio voice, initiating and maintaining the tachycardia. Three-dimensional electroanatomic mapping during electrophysiology study localized the tachycardia to the ostium of the right superior pulmonary vein. After single radiofrequency energy application, no further arrhythmias were inducible with speech. At more than 1 year of follow-up, the patient had no recurrences and continues to work as a radio announcer.

Silence Is Golden

“…Speech-induced AT is rare, and only sporadic cases were reported. [2][3][4] However, the underlying mechanism is unclear. In our case, we found that an increase in LAP preceded the episode of AT.…”

“…In fact, similar viewpoints have been revealed by a few previous reports. [2][3][4] Nevertheless, the exact mechanism of speech-induced AT remains to be elucidated in the future.…”

“…1) However, speechinduced AT is extremely rare. [2][3][4] Here, we report a case of speech-induced AT and its relevant electrophysiological characteristics.…”

Social anxiety provoked by speech-induced atrial tachycardia

“…AT and AF have been reported with coughing, speaking, and swallowing 2, 3, 4, 5, 6, 7. One case localized the site of earliest activation to the roof of the left atrium, whereas another noted earliest activation was in the anteroseptum of the left atrium 2, 3.…”

“…AT and AF have been reported with coughing, speaking, and swallowing. 2 , 3 , 4 , 5 , 6 , 7 One case localized the site of earliest activation to the roof of the left atrium, whereas another noted earliest activation was in the anteroseptum of the left atrium. 2 , 3 Fan et al 2 postulated that it may be due to an anomalous efferent input from the recurrent laryngeal nerve to the left atrial ganglionic plexuses.…”