Syncope caused by swallow-induced A-V nolal reentry tachycardia: a case repert
0
Citation
0
Reference
20
Related Paper
Keywords:
Reentry
A case of neurocardiogenic syncope is reported in which both AV-reciprocating tachycardia due to a concealed retrogradely conducting posteroseptal bypass tract and paroxysmal atrial fibrillation were observed. In connection with this case, attention is paid to the difficulties of differential diagnosis and to the pathophysiological correlations concerning the occurrence of neurocardiogenic/vasovagal reflex syncope and cardiac arrhythmias. A prolonged period of freedom from syncope and tachycardia was achieved by means of drug treatment, through the combined administration of disopyramide, bisoprolol and theophylline.
Vasovagal Syncope
Paroxysmal tachycardia
Disopyramide
Cite
Citations (1)
Esophageal disease
Cite
Citations (1)
Palpitations
Cite
Citations (0)
Swallow syncope is a rare neurally-mediated syncope syndrome. The majority of patients experience brady-arrhythmias on swallowing with the event leading to systemic hypotension. The diagnosis is suspected from the temporal relation between swallowing and the syncopal event, and confirmed by concomitant bradycardia. The diagnosis is suspected from the temporal relation between swallowing and the syncopal event, and confirmed by concomitant swallow-induced symptoms with bradycardia. Underlying oesophageal disease may be present in about 40% of patients necessitating investigations for oesophageal pathology. Recurrent syncopal symptoms can be prevented by placing a cardiac pacemaker. We present a case of swallow syncope and complete heart block successfully treated with a pacemaker.
Concomitant
Atrioventricular block
Cite
Citations (0)
Electrophysiologic study
Cite
Citations (12)
Hospital medicine
General hospital
Cite
Citations (4)
Cerebral Hypoperfusion
Pathophysiology
Carotid sinus
Sinus bradycardia
Sinus (botany)
Cite
Citations (4)
Reentry
Vagovagal reflex
Cite
Citations (0)
Key Teaching Points•Reflex syncope is common in the young and typically is benign. We present a case of reflex syncope associated with nonsustained polymorphic ventricular tachycardia.•In susceptible individuals, autonomic stimuli may trigger significant arrhythmias, other than the anticipated bradyarrhythmias.•In some individuals with no apparent risk factors, autonomic nervous system miscues may lead to life-threatening arrhythmias, with the potential for progressing to sudden cardiac arrest.•This case may provide insight into the 50% of individuals who experience a cardiac arrest with no identifiable cause. •Reflex syncope is common in the young and typically is benign. We present a case of reflex syncope associated with nonsustained polymorphic ventricular tachycardia.•In susceptible individuals, autonomic stimuli may trigger significant arrhythmias, other than the anticipated bradyarrhythmias.•In some individuals with no apparent risk factors, autonomic nervous system miscues may lead to life-threatening arrhythmias, with the potential for progressing to sudden cardiac arrest.•This case may provide insight into the 50% of individuals who experience a cardiac arrest with no identifiable cause.
Cite
Citations (3)
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 tachydysrhythmiaConclusions
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.Supraventricular Tachycardia
Cite
Citations (0)