Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects.

Background: Syncope triggered by swallowing is a well‐known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected sw...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Cardiovascular Electrophysiology Vol. 30; no. 2; pp. 221 - 230
Autores principales: Kohno, Ritsuko, Adkisson, Wayne O., Detloff, Barry L. S., Sakaguchi, Scott, Benditt, David G.
Formato: research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Feb2019
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134535728&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 134535728
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10453873
        GSB
      jtl: Journal of Cardiovascular Electrophysiology
      issn: 10453873
      maglogo: Y
    pubinfo:
      dt: Feb2019
      vid: 30
      iid: 2
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        134535728
        134535728
        134535728
        10.1111/jce.13780
        134535728
      ppf: 221
      ppct: 9
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: C
          – @attributes:
              type: P
      tig:
        atl: Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects.
      aug:
        au:
          Kohno, Ritsuko
          Adkisson, Wayne O.
          Detloff, Barry L. S.
          Sakaguchi, Scott
          Benditt, David G.
        affil: Cardiovascular Division, Cardiac Arrhythmia Center, University of Minnesota, Minneapolis Minnesota
      sug:
        subj:
          Heart Rate Evaluation
          Blood Pressure Determination
          Hemodynamics
          Deglutition
          Syncope Diagnosis
          Human
          Male
          Female
          Valsalva's Maneuver
          Massage
          Decision Making, Clinical
          Male
          Female
      ab: Background: Syncope triggered by swallowing is a well‐known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected swallow syncope patients and asymptomatic control subjects. Methods: The study population comprised four individuals with a history suggesting swallow syncope (three men, 53 ± 14.9 years) and 15 (nine men, 46 ± 17.1 years, P = NS vs patients) asymptomatic volunteer control subjects. Studies in all individuals comprised noninvasive beat‐to‐beat HR and BP measurement during swallowing 150 mL of cold liquid while standing. Additional tests in swallow syncope patients included: active standing, Valsalva maneuver, carotid sinus massage (CSM), and head‐up tilt (HUT). Results: Swallowing resulted in a greater decrease of both HR (−22 ± 22.1 vs −3 ± 11.7 beats/minute [bpm]; P = 0.045) and BP (−22 ± 17.4 vs − 2 ± 11.8; P = 0.036) in swallow syncope patients than in controls. Further, in swallow syncope patients the time to lowest HR and BP differed (9 ± 5.5 vs 19 ± 7.2 seconds; P = 0.02), suggesting that both cardioinhibitory (CI) and vasodepressor (VD) mechanisms are present but operate independently. Other autonomic studies were normal in swallow syncope patients except for CSM pause more than 3 seconds in two patients. Conclusion: Swallow syncope is associated with transient and temporally independent CI and VD features, consistent with reflex syncope. Potentially, a swallowing test during autonomic evaluation may be useful to unmask relative magnitudes of CI and VD responses, thereby facilitating treatment strategy decisions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N