Document Detail


High-resolution esophageal manometry with ECG monitoring for management of premature ventricular complexes-associated dysphagia.
MedLine Citation:
PMID:  19653039     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a novel technique for diagnosing a new cause of esophageal dysphagia in a patient without organic heart and esophageal disease. A coincidence between intermittent esophageal dysphagia and cardiac arrhythmia, frequent premature ventricular complexes (PVC) were confirmed by clinical observation, simultaneous ECG monitoring, and motility study. High-resolution esophageal manometry (HRM) revealed abnormal peristaltic waves only during frequent PVC. Abnormal peristaltic waves and PVC disappeared simultaneously and completely within 15 min after intravenous infusion of antiarrhythmic agent (140 mg propafenone). Oral treatment with antiarrhythmic drugs was not tolerated or ineffective. Complete remission of PVC and dysphagia was achieved immediately after radiofrequency catheter ablation of arrhythmogenic focus located in the right ventricular outflow tract. This case demonstrates a new technique for the management of a syndrome called "PVC-associated dysphagia" that can be mediated by cardioesophageal reflex. Interdisciplinary cooperation and simultaneous HRM with ECG monitoring may confirm the diagnosis and guide effective treatment.
Authors:
Sebastian Stec; Wieslaw Tarnowski; Katarzyna Kalin; Krzysztof Sikora; Piotr Kulakowski
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-04
Journal Detail:
Title:  Dysphagia     Volume:  25     ISSN:  1432-0460     ISO Abbreviation:  Dysphagia     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610856     Medline TA:  Dysphagia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Grochowski Hospital, Warsaw, Poland. smstec@wp.pl
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MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / therapeutic use*
Deglutition Disorders / diagnosis*,  etiology*
Drug Monitoring
Electrocardiography*
Female
Humans
Manometry / instrumentation*
Middle Aged
Propafenone / therapeutic use*
Ventricular Premature Complexes / complications*,  physiopathology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 54063-53-5/Propafenone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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