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Related Experiment Video

Updated: Dec 19, 2025

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Deglutition Syncope Treated With Peroral Endoscopic Myotomy.

Katherine M Klein1, Yahya Alwatari1, Jayanthi N Koneru2

  • 1Division of Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, Virginia.

The Annals of Thoracic Surgery
|June 4, 2020
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Summary

Deglutition syncope, a rare swallowing-induced reflex, can cause fainting. This case highlights peroral endoscopic myotomy as a successful treatment for persistent syncope due to esophagogastric junction outflow obstruction.

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Area of Science:

  • Gastroenterology
  • Cardiology
  • Neurology

Background:

  • Deglutition syncope is a rare neurally mediated reflex syncope linked to swallowing, often caused by pharyngoesophageal issues.
  • It can lead to atrioventricular cardiac block and cerebral hypoperfusion due to abnormal vagal reflex.
  • Diagnosis is often delayed and challenging.

Observation:

  • The study presents a case of persistent deglutition syncope.
  • The syncope was secondary to esophagogastric junction outflow obstruction.
  • This condition failed to respond to medical therapy.

Findings:

  • Peroral endoscopic myotomy (POEM) was successfully employed to manage the persistent deglutition syncope.
  • The patient experienced an excellent long-term outcome following the procedure.

Implications:

  • Peroral endoscopic myotomy is a viable and effective treatment option for deglutition syncope caused by esophagogastric junction outflow obstruction.
  • This approach offers a successful alternative when medical therapies fail.
  • The findings suggest a potential new management strategy for this rare condition.