Non-contact three-dimensional mapping and ablation of swallowing-induced atrial tachyarrhythmias: two case reports

We describe two cases of swallowing-induced tachyarrhythmias that were cured by radiofrequency ablation (RFCA) using a non-contact mapping system (NCMS). In both patients, tachyarrhythmias occurred during swallowing solids and liquids, and mapping and ablation of the arrhythmia using the NCMS was attempted during swallowing a rice ball. During a premature atrial contraction shortly after the swallow, the earliest endocardial breakthrough occurred at the right superior pulmonary vein (PV) ostium in Case 1 and at the left superior PV ostium and postero-inferior right atrium in Case 2. Guided by the NCMS catheter navigation system, the ablation catheter was easily and precisely positioned at a site where the earliest endocardial breakthrough occurred. RFCA at that site resulted in success and no recurrence or complications occurred during the follow-up in either patient.