Key result
ECGi combined with high-density mapping successfully guides ablation of swallowing-induced atrial tachycardia.
Why the study?
Swallowing-induced atrial tachycardia is a rare arrhythmia with unclear pathophysiology that is often resistant to antiarrhythmic medications and difficult to induce and map during electrophysiology studies.
Case Report (n=1)
A stepwise approach using noninvasive electrocardiographic imaging (ECGi) and high-density endocardial mapping can successfully localize and guide the ablation of challenging, drug-refractory swallowing-induced atrial tachycardia.
Answers are grounded in this paper and cite their sources.
May support ECGi-guided ablation for rare swallowing-induced atrial tachycardia; leaves open prospective validation in larger cohorts.
Swallowing-induced atrial tachycardia (SIAT) is rarely encountered in clinical practice, with a reported prevalence of approximately 0.6%.1 Its pathophysiology is not clearly understood although mechanical stimulation by the distended esophagus and vagal or adrenergic reflexes are among the postulated mechanisms.2–5 The arrhythmia can be exceptionally challenging because it is often resistant to antiarrhythmic medications and difficult to induce and map during an electrophysiology study under conscious sedation with standard pharmacologic augmentation or electrical stimulation.
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Batul et al. (2025) conducted a case report in Swallowing-induced atrial tachycardia (n=1). Noninvasive electrocardiographic imaging (ECGi) and high-density endocardial mapping-guided ablation was evaluated on Arrhythmia elimination and symptom resolution. Noninvasive electrocardiographic imaging combined with high-density endocardial mapping successfully localized and guided the ablation of swallowing-induced atrial tachycardia, eliminating symptoms at 6 months.
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