Swallowing-induced atrial tachyarrhythmias: prevalence, characteristics, and the results of the radiofrequency catheter ablation.
BACKGROUND
Detailed information on swallowing-induced tachyarrhythmias has been lacking.


METHODS
The prevalence, characteristics, and results of the radiofrequency catheter ablation (RFCA) of swallowing-induced tachyarrhythmias were examined in 544 patients with symptomatic premature atrial contractions (PACs), paroxysmal atrial tachycardia (AT), and/or paroxysmal atrial fibrillation (AF). We also conducted a search of the medical literature on swallowing-induced tachyarrhythmias. Further, we presented an in-depth review of the literature and investigated the published data on swallowing-induced tachyarrhythmias.


RESULTS
The prevalence of swallowing-induced tachyarrhythmias was 0.6% (three patients). An analysis of the published literature and our three cases demonstrated that (1) males predominated 9:1 over females, (2) most cases occurred over 35 years of age, (3) tachyarrhythmias occurred consistently and reproducibly shortly after each swallow, (4) 90% of the patients had PACs and/or AT as the manifesting arrhythmia, (5) the PACs provoked by swallowing usually had the same P-wave morphology as the first beat of the AT and AF, and (6) RFCA procedures performed in five cases resulted in success with no recurrence or complications.


CONCLUSIONS
Swallowing-induced tachyarrhythmias are rare, but have several distinct characteristics. RFCA should be considered in appropriately selected patients with reliable inducibility because such an ablation may offer a permanent cure.
Tada
Hiroshi
H
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. htada@umich.edu
Kaseno
Kenichi
K
Kubota
Shoichi
S
Naito
Shigeto
S
Yokokawa
Miki
M
Hiramatsu
Shigeki
S
Goto
Koji
K
Nogami
Akihiko
A
Oshima
Shigeru
S
Taniguchi
Koichi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology; D017115:Catheter Ablation; D002648:Child; D003679:Deglutition; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*