Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Swallowing-Induced Atrial Tachyarrhythmias Successfully Ablated at the Left Posterior Interatrial Septum in Patient with Wolff-Parkinson-White Syndrome

  • Ban, Ji-Eun (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Park, Sang-Weon (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Lee, Hyun-Soo (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Choi, Jong-Il (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Young-Hoon (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine)
  • Received : 2014.05.28
  • Accepted : 2014.09.01
  • Published : 2015.05.30
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Abstract

We reported a case of a 55-year-old patient who presented with palpitation after swallowing. Initial surface electrocardiogram revealed ventricular preexcitation utilizing a left lateral bypass tract. The orthodromic atrioventricular reentrant tachycardia (AVRT) was induced during electrophysiologic studies. After successful ablation of the AVRT utilizing a left lateral free wall bypass tract, 2 different atrial tachycardias (ATs) were induced under isoproterenol infusion. When the patient swallowed saliva or drank water, 2 consecutive beats of atrial premature complexes (APCs) preceded another non-sustained AT repeatedly, which was coincident with the patient's symptom. The preceding APC couplet had the same activation sequence with one induced AT, and the subsequent non-sustained AT had the same activation sequence with the other induced AT, respectively. We first targeted the preceding 2 consecutive APCs at the left posterior interatrial septum. The following non-sustained AT was also eliminated following ablation of the APCs. After ablation, the patient remained free from the swallowing-induced atrial tachyarrhythmias during the one year follow-up.

Keywords

References

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