The Source of Heart Rhythm Changes Caused by Swallowing

Swallowing can lead to the development of syncope in people who have difficulty swallowing during food intake. It has shown that even spontaneous saliva swallowing can change heart rate variability (HRV). Recently, it has been suggested that changes in heart rate during swallowing may be caused by respiratory activities. In this study, the hypothesis that swallowing induced HRV are caused from breathing changes during swallowing has been tested. For this purpose, electrocardiogram (ECG), chest circumference (respiration) signals and swallowing sounds were recorded simultaneously from 20 subjects. Subjects were asked not to swallow their saliva in the first 4 min of the experiment and to swallow them several times in the next 4 min. To observe respiratory effects on HRV during swallowing, a detailed cardio-respiratory system mathematical model was used. By applying recorded chest circumference signal to the mathematical model, respiration induced HRV changes were obtained. The HRV parameters of with and without swallowing regions of the real (obtained from ECG) and model-HRV (obtained from mathematical model) were compared by paired Student t test. Statistical differences seen in the real-HRV between the swallowing and non-swallowing regions (SDNN, LF power, approximate entropy) were not observed in the model-HRV. Considering that the only factor constituting HRV in the mathematical model is respiration, it was concluded that swallowing changes HRV with a mechanism other than breathing changes.