To eat, or not to eat…?: A live video case of swallowing-induced atrial tachycardia

Case evaluation A 12-lead baseline electrocardiogram at admission showed sinus rhythm without signs of ischemia. There were no abnormal findings on physical examination. Biochemical blood evaluation showed no abnormalities. An echocardiogram revealed a normal morphology and function of the heart. Holter monitoring revealed bouts of regular supraventricular tachycardia while eating, with a maximal duration of 4 seconds and a ventricular response r210 beats per minute (bpm) (Figure 1). We filmed such an episode (Supplemental Video available online; Video stills 1 and 2). Clearly, runs of narrow complex tachycardia arise in short salvos during the swallowing phase. In between swallows, the heart converts to normal sinus rhythm. At the end of the recording, the tachycardia is characterized by aberrant conduction.