Curative therapy for swallowing-induced tachycardia by pulmonary vein antrum isolation.

We present a case of a 49-year-old man who experienced invariably reproducible paroxysmal supraventricular tachycardia during swallowing. Because beta-blockers and multiple antiarrhythmic drugs failed to prevent the episodes of this tachycardia, we performed catheter mapping and ablation. After placing multiple decapolar catheters, when the patient swallowed a few sections of an orange, intracardiac mapping revealed atrial premature beats and atrial tachycardia that lasted for a few seconds and arose from an ostial site of the right superior pulmonary vein. After the right superior pulmonary vein antrum was completely isolated, the patient became free from the swallowing-induced tachycardia.