GW24-e0080 Swallowing-induced AVNRT and syncope

Objectives Swallowing-induced tachyarrhythmia (SIT) is a rare clinical supraventricular arrhythmia where premature atrial contractions (PAC) or paroxysmal supraventricular tachycardia (PAT) (i.e atrial tachycardia AT, atrial fibrillation AF, atrioventricular tachycardia AVT, atrioventricular nodal re-entrant tachycardia AVNRT) occur frequently and reproducibly during a wet or dry swallow. Methods A 59-year-old female was admitted to the Department of Gastroenterology due to recurrent postprandial abdominal discomfort. In the past week, the patient had on three occasions experienced postprandial epigastric discomfort with concomitant syncopal attack and limb convulsion. Each event last around two min and the patient recovered spontaneously. Results The mechanisms behind swallowing-induced tachycardia are not clearly understood; most cases had no history of cardiac or esophageal diseases. Disturbed peristalsis has been proposed to induce tachycardia as stimulation of the anterior esophageal wall has been shown to consistently trigger tachydysrhythmia Conclusions In conclusion, we report a case of syncopal SVNRT which was initiated by swallowing-induced premature atrial contractions where radiofrequecy ablation was an effective way to treat symptomatic SVNRT induced by swallowing. We propose that swallowing-induced SVT is associated with changes in autonomic nerve tone.