title: Swallowing-induced atrial tachyarrhythmias successfully ablated at the left posterior interatrial septum in patient with wolff-Parkinson-white syndrome.
abstract: We reported a case of a 55-year-old patient who presented with palpitation after swallowing. Initial surface electrocardiogram revealed ventricular preexcitation utilizing a left lateral bypass tract. The orthodromic atrioventricular reentrant tachycardia (AVRT) was induced during electrophysiologic studies. After successful ablation of the AVRT utilizing a left lateral free wall bypass tract, 2 different atrial tachycardias (ATs) were induced under isoproterenol infusion. When the patient swallowed saliva or drank water, 2 consecutive beats of atrial premature complexes (APCs) preceded another non-sustained AT repeatedly, which was coincident with the patient's symptom. The preceding APC couplet had the same activation sequence with one induced AT, and the subsequent non-sustained AT had the same activation sequence with the other induced AT, respectively. We first targeted the preceding 2 consecutive APCs at the left posterior interatrial septum. The following non-sustained AT was also eliminated following ablation of the APCs. After ablation, the patient remained free from the swallowing-induced atrial tachyarrhythmias during the one year follow-up.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Ban
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sang-Weon
authors.initials: SW
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jong-Il
authors.initials: JI
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
keywords: Atrial tachycardia; Catheter ablation; Deglutition