Key result
Flecainide plus verapamil prevents recurrent deglutition-induced atrial fibrillation in Laing distal myopathy over 1 year.
Why the study?
Swallowing-induced tachycardia is a rare condition with limited effective treatment options, and catheter ablation targeting the pulmonary vein antrum may offer a curative approach.
Case Report (n=1)
May inform management of rare swallow-induced AF; leaves open need for controlled validation.
We present a case of a 49-year-old man who experienced invariably reproducible paroxysmal supraventricular tachycardia during swallowing. Because beta-blockers and multiple antiarrhythmic drugs failed to prevent the episodes of this tachycardia, we performed catheter mapping and ablation. After placing multiple decapolar catheters, when the patient swallowed a few sections of an orange, intracardiac mapping revealed atrial premature beats and atrial tachycardia that lasted for a few seconds and arose from an ostial site of the right superior pulmonary vein. After the right superior pulmonary vein antrum was completely isolated, the patient became free from the swallowing-induced tachycardia.
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Yamauchi et al. (2005) conducted a case report in Deglutition-induced atrial fibrillation (n=1). Flecainide and verapamil was evaluated on Recurrence of atrial fibrillation and symptoms of palpitations. Flecainide in combination with verapamil successfully prevented the recurrence of deglutition-induced atrial fibrillation in a patient with Laing distal myopathy over a 1-year follow-up.
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