Swallowing-dependent atrial tachyarrhythmias. Their mechanism

We describe here the case of one patient who exhibited several types of atrial tachyarrhythmias induced by swallowing. There was no evidence of other cardiac or gastroesophagic abnormalities. The electrophysiologic study demonstrated a second degree A-V block due to block within the atria. Our findings suggest that the mechanism operative may be an intra-atrial micro-reentry induced by an increased vagovagal reflex triggered by the normal esophageal peristalsis.