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Related Experiment Videos

Swallow syncope.

Komandoor Srivathsan1, Richard W Lee

  • 1Division of Cardiovascular Diseases, Mayo Clinic Scottsdale, 13400 East Shea Blvd., Scottsdale, AZ 85259.

Pacing and Clinical Electrophysiology : PACE
|April 18, 2003
PubMed
Summary
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Swallow syncope, a rare condition triggered by swallowing, can cause dangerous heart rhythm disruptions. Pacemaker implantation effectively treated a patient experiencing complete atrioventricular block due to this reflex.

Area of Science:

  • Cardiology
  • Neurology
  • Autonomic Nervous System

Background:

  • Swallow syncope is a rare condition characterized by a hypersensitive vagotonic reflex triggered by deglutition.
  • It can lead to transient cardiovascular events, including syncope and atrioventricular (AV) block.

Observation:

  • A 26-year-old male presented with recurrent light-headedness and near syncope associated with swallowing.
  • Continuous electrocardiographic and invasive arterial pressure monitoring revealed that solid meal ingestion provoked light-headedness and a 5.6-second complete AV block without an escape rhythm.

Findings:

  • The patient experienced a significant and prolonged complete atrioventricular block upon swallowing, indicating a severe vagotonic reflex.
  • Electrophysiological monitoring confirmed the link between deglutition and the cardiac event.

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Implications:

  • This case highlights the importance of considering swallow syncope in patients with unexplained syncopal episodes related to eating.
  • Pacemaker implantation, specifically with a rate drop feature, can be an effective treatment for severe, symptomatic swallow syncope.
  • Further research into the pathophysiology and management of this rare condition is warranted.