Paroxysmal supraventricular tachycardia initiated by a swallowing-induced premature atrial beat

San Jou Yeh, Morgan Fu, Fun Chung Lin, Chau Hsiung Chang, Jui Sung Hung

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations


We report a unique patient in whom electrophysiologic studies elucidated the mechanism of a rare form of swallowing-induced atrioventricular reentrant tachycardia, and for whom successful surgical ablation of an accessory pathway abolished intractable episodes of palpitation. A 64-year-old man was incapacitated by frequent attacks of palpitation following swallowing. Electrocardiograms documented paroxysmal supraventricular tachycardias initiated by a premature atrial beat or beats following swallowing. During electrophysiologic studies swallowing consistently induced premature atrial beats which in turn initiated a sustained atrioventricular reentrant tachycardia incorporating a retrogradely conducting left-sided concealed accessory pathway. The atrial activation sequence related to the premature atrial beats and the morphology of the premature P waves suggested that premature atrial beats orginated in the right atrium. The mechanism of induction of premature atrial beats following swallowing remains obscure in our patient. Antiarrythmic drugs failed to prevent induction of sustained tachycardias during sequential electrophysiologic studies. The patient underwent successful surgical ablation of the accessory pathway and is free from palpitation 15 months after the surgery.

Original languageEnglish
Pages (from-to)193-196
Number of pages4
JournalJournal of Electrocardiology
Issue number2
StatePublished - 1986


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