Deglutition-induced Atrial Tachycardia Localised with Contact Force-guided Activation Mapping

Deglutition-induced atrial tachycardia is a rare arrhythmia with a poor response to medical therapy. Electrophysiological study is challenging due to the dependence of induction on swallowing. We present a novel approach to management of deglutition-induced atrial tachycardia arising from right supe...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2016-11, Vol.25 (11), p.e152-e154
Main Authors: McLellan, Alex J.A., MBBS, Bates, Matthew G.D., MB ChB PhD, Young, Shane D.F., BHMSc MSc, Sparks, Paul B., MBBS PhD
Format: Article
Language:English
Subjects:
Aged
Cardiovascular
Contact-force sensing catheter
Deglutition
Deglutition-induced atrial tachycardia
Electrophysiologic Techniques, Cardiac
Humans
Male
Pulmonary vein isolation
Tachycardia - physiopathology
Tachycardia - therapy
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Summary:Deglutition-induced atrial tachycardia is a rare arrhythmia with a poor response to medical therapy. Electrophysiological study is challenging due to the dependence of induction on swallowing. We present a novel approach to management of deglutition-induced atrial tachycardia arising from right superior pulmonary vein. Use of minimal conscious sedation and repeated swallow challenge inductions, together with contact force-guided mapping were key determinants of success. We review published cases, discussing potential mechanisms including oesophageal distension and neural reflexes.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2016.01.014