Key result
Demand pacemaker placement resolves symptoms in a patient with recurrent swallow-induced complete AV block.
Why the study?
Swallow syncope is a very unusual but treatable disorder characterized by recurrent complete atrioventricular block associated with swallowing.
Does demand cardiac pacemaker placement resolve symptoms in a patient with swallow syncope associated with complete atrioventricular block?
Case Report (n=1)
Does demand cardiac pacemaker placement resolve symptoms in a patient with swallow syncope associated with complete atrioventricular block?
Swallow syncope is a rare but potentially lethal disorder that can be successfully treated with a demand cardiac pacemaker.
May support pacemaker consideration in swallow syncope with AV block; single case leaves open need for confirmatory studies.
Swallow or deglutition syncope is a very unusual but treatable disorder. A 44-year-old male presented with multiple, recurrent episodes of complete atrioventricular block associated with swallowing. Over a 24-hour period, 92 episodes of complete atrioventricular block occurring with meals were recorded by Holter monitoring. Evaluation did not demonstrate any underlying esophageal or cardiac disease. A trial of anticholinergic medications was unsuccessful. The patient's symptoms resolved following placement of a demand cardiac pacemaker. This is a rare but potentially lethal disorder that can be successfully treated if recognized. Physicians should be alerted to symptoms of lightheadedness or syncope during meals.
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Elam et al. (1989) conducted a case report in Swallow syncope with complete atrioventricular block (n=1). Demand cardiac pacemaker was evaluated on Symptom resolution. Placement of a demand cardiac pacemaker successfully resolved symptoms in a patient with recurrent complete atrioventricular block associated with swallowing.
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