Permanent Pacemaker Placement

Permanent pacemaker placement for the treatment

of deglutition syncope

Presented by:

(Poster pending)

Kristine L. Cueva

Medical Student

Drexel University College of Medicine

Kristine L Cueva; Mohan A Zopey; Yasser A Al-Antably, MD

Department of Gastroenterology and Hepatology, Kaiser Permanente South Sacramento Medical Center

Abstract:

Deglutition (swallow) syncope is a rare form of situational syncope with limited reports in literature. It is caused by stimulation of the vagovagal reflex through stretch activation of mechanoreceptors in the esophagus, leading to cardioinhibition and/or vasodepression. Patients may experience transient loss of consciousness (syncope) or dizziness (presyncope) immediately during or after swallowing. Several trigger factors have been presented for swallow syncope, including the amount, type, temperature, and texture of foods and/or liquids. Careful history, documented trigger association, ambulatory electrocardiogram monitoring, and investigation of any underlying causes are essential for diagnosis. Permanent pacemaker placement has been shown to be successful in preventing further swallow syncopal episodes in cases without any other treatable underlying diseases. In this report, we present a 64 year old man with swallow syncope associated with a high degree atrioventricular block, which resolved with permanent pacemaker placement.

Keywords: deglutition syncope, pacemaker, atrioventricular block