A case of swallow syncope induced by vagovagal reflex.
A 65-year-old man experienced syncope associated with advanced atrioventricular (AV) block upon swallowing. Continuous electrocardiogram (ECG) monitoring revealed first and second degree AV block. ECG revealed advanced AV block (Max R-R 6.38 s) upon swallowing, a cold drink. Demand ventricular pacing alleviated his symptoms. In this patient, the advanced AV block might have been precipitated by a vagovagal reflex triggered by expansion of the esophagus, resulting in selective suppression of the atrioventricular node.
Kunimoto
S
S
Department of Internal Medicine, Oji General Hospital, Tomakomai, Japan.
Sibata
S
S
Abiru
M
M
Takigami
Y
Y
Fujise
Y
Y
Hanawa
K
K
Yamaji
I
I
Shimamoto
K
K
Iimura
O
O
D000368:Aged; D001283:Atrioventricular Node / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D003679:Deglutition / Q000502:physiology*; D004947:Esophagus / Q000294:innervation / Q000503:physiopathology; D006327:Heart Block / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D012018:Reflex / Q000502:physiology*; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014630:Vagus Nerve / Q000503:physiopathology*