A CASE OF SWALLOWING-INDUCED ATRIOVENTRICULAR-BLOCK AFTER MYOCARDIAL-INFARCTION

We report a patient with transient atrioventricular (AV) block induced by swallowing. He complained of recurrent dizziness during meals and had suffered from inferior myocardial infarction 1 year before the ons et of these symptoms. Radiologic examination showed no apparent esopha geal abnormalities. Swallowing a piece of solid food or hot liquid rep eatedly provoked advanced AV block. Administration of intravenous atro pine sulfate prevented AV block. An electrophysiologic study revealed that this swallowing-induced AV block was an intranodal (A-H) block. W e did not implant a cardiac pacemaker because his symptoms were not ve ry serious and could be prevented by eating carefully. The patient has been symptom-free for the past 12 months. The previous myocardial inf arction may be related to the appearance of this vagal-related AV bloc k.