Swallowing-induced atrial tachyarrhythmias: prevalence, characteristics, and the results of the radiofrequency catheter ablation

Abstract

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.