Key result
DDDR pacing with rate drop response eliminates recurrent swallow syncope over 2 years.
Why the study?
Swallow syncope is a rare disorder caused by hypersensitive vagotonic reflex in response to deglutition requiring clinical evaluation and management.
Does a DDDR pacemaker with rate drop feature prevent symptoms in a patient with swallow syncope?
Case Report (n=1)
Does a DDDR pacemaker with rate drop feature prevent symptoms in a patient with swallow syncope?
A DDDR pacemaker with a rate drop feature successfully prevented symptoms in a patient with swallow syncope caused by complete AV block.
Supports DDDR pacing with rate-drop response in swallow syncope; hypothesis-generating and requires prospective validation before practice change.
Swallow syncope is a rare disorder caused by hypersensitive vagotonic reflex in response to deglutition. A 26-year-old man complained of recurrent light-headedness and near syncope on swallowing was hospitalized for monitoring and evaluation. Continuous electrocardiographic and invasive arterial pressure monitoring showed ingestion of a solid meal evoked light-headedness and complete AV block without an escape rhythm that lasted for 5.6 seconds. This patient received a Medtronic Kappa (401B) DDDR pacemaker with the rate drop feature. The patient has remained asymptomatic on follow-up for the past 2 years.
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Srivathsan et al. (2003) conducted a case report in Swallow syncope (n=1). Medtronic Kappa (401B) DDDR pacemaker with rate drop feature was evaluated on Symptoms of syncope or light-headedness.
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