Korean Circ J.  2010 Feb;40(2):99-101. 10.4070/kcj.2010.40.2.99.

Deglutition Syncope Associated With Ventricular Asystole in a Patient With Permanent Atrial Fibrillation

Affiliations
  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. juneskim@skku.edu
  • 3Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.

Abstract

Deglutition syncope is a situational syncope that is diagnosed only by a detailed history. We report deglutition syncope in a 62-year-old man, who had permanent atrial fibrillation. The patient had no structural or functional abnormalities of the esophagus. During syncopal attacks, his electrocardiography showed ventricular asystole that was sustained for 12 seconds. The patient was successfully treated by implantation of a permanent pacemaker.

Keyword

Syncope; Deglutition; Atrial fibrillation

MeSH Terms

Atrial Fibrillation
Deglutition
Electrocardiography
Esophagus
Heart Arrest
Humans
Middle Aged
Syncope

Figure

  • Fig. 1 In a patient with recurrent syncope and permanent atrial fibrillation, ventricular asystole suddenly developed after dinking a cold beverage. The patient lost consciousness during ventricular asystole (Paper speed 12.5 mm/s).

  • Fig. 2 Ventricular asystole was induced by drinking a cold beverage (Paper speed: 12.5 mm/s).

  • Fig. 3 After permanent pacemaker implantation, the patient did not lose consciousness after drinking a cold beverage. ECG monitoring showed ventricular paced beats rather than ventricular asystole (Paper speed: 25 mm/s). ECG: electrocardiogram.


Reference

1. Rhee KS. Cough syncope induced by gastroesophageal reflux. Korean Circ J. 2004. 34:718–720.
2. Kapoor WN. Syncope. N Engl J Med. 2000. 343:1856–1862.
3. Sapru RP, Griffiths PH, Guz A, Eisele J. Syncope on swallowing. Br Heart J. 1971. 33:617–622.
4. Kunimoto S, Sibata S, Abiru M, et al. A case of swallow syncope induced by vagovagal reflex. Jpn J Med. 1990. 29:199–202.
5. Cherukuri S, Gardner GM. Deglutition syncope. Otolaryngol Head Neck Surg. 2004. 130:145–147.
6. Kunis RL, Garfein OB, Pepe AJ, Dwyer EM Jr. Deglutition syncope and atrioventricular block selectively induced by hot food and liquid. Am J Cardiol. 1985. 55:613.
7. Kakuchi H, Sato N, Kawamura Y. Deglutition syncope associated with complete atrioventricular block and vasovagal syncope. Heart. 2000. 83:702–704.
8. Omi W, Murata Y, Yaegashi T, Inomata J, Fujioka M, Muramoto S. Swallow syncope, a case report and review of the literature. Cardiology. 2006. 105:75–79.
9. Gordon J, Saleem SM, Ngaage DL, Thorpe JA. Swallow syncope associated with paroxysmal atrial fibrillation. Eur J Cardiothorac Surg. 2002. 21:587–590.
10. Maekawa T, Suematsu M, Shimada T, Go M, Shimada T. Unusual swallow syncope caused by huge hiatal hernia. Intern Med. 2002. 41:199–201.
11. Armstrong PW, McMillan DG, Simon JB. Swallow syncope. Can Med Assoc J. 1985. 132:1281–1284.
Full Text Links
  • KCJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr