Swallowing-induced paroxysmal supraventricular tachycardia.

A 54-year-old man had palpitations on swallowing without any esophageal or heart disease. Electrophysiological findings, including an A wave in the high right atrial leads appearing prior to the A wave on His bundle electrogram, revealed that the arrhythmia was paroxysmal supraventricular tachycardia originating in an ectopic focus of the atrium with intraventricular aberration. Treatment with verapamil, 120 mg/day, reduced his symptoms in spite of an insignificant decrease in the arrhythmia observed with Holter dynamic electrocardiography.