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Eur J Cardiothorac Surg 2002;21:587-590
© 2002 Elsevier Science NL

Case report

Swallow syncope associated with paroxysmal atrial fibrillation

Department of Cardio Thoracic Surgery, Yorkshire Heart Centre, Jubilee Wing, D-Floor, The General Infirmary, Leeds LS1 3EX, UK

Received 28 April 2001; received in revised form 14 December 2001; accepted 18 December 2001.

* Corresponding author. Tel.: +44-113-392-5736; fax: +44-113-392-8436
e-mail: thorpyat{at}aol.com

Swallow or deglutition syncope is a very unusual potentially lethal but treatable disorder. We report the case of a 26-year-old woman, who presented with a history of recurrent, multiple fainting episodes precipitated by swallowing. Twenty-four-hour manometry and pH recording together with continuous 24-h ECG monitoring revealed multiple episodes of symptomatic and asymptomatic paroxysmal atrial fibrillation, and significant gastro-oesophageal reflux associated with swallowing. Oesophageal function tests and continuous electrocardiographic evaluation is important in the diagnosis of this rare condition.

Key Words: Swallow syncope • Syncopal syndromes • Paroxysmal atrial fibrillation • Esophageal function tests • Gastroesophageal reflux