Skip to main content
SpringerLink
Log in

High-Resolution Esophageal Manometry with ECG Monitoring for Management of Premature Ventricular Complexes-Associated Dysphagia

  • Case Report
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Galmiche JP, Clouse RE, Bálint A, Cook IJ, Kahrilas PJ, Paterson WG, et al. Functional esophageal disorders. Gastroenterology. 2006;130:1459–65. doi:10.1053/j.gastro.2005.08.060.

    Article  PubMed  Google Scholar 

  2. Pandolfino JE, Kahrilas PJ. AGA technical review on the clinical use of esophageal manometry. Gastroenterology. 2005;128:209–24. doi:10.1053/j.gastro.2004.11.008.

    Article  PubMed  Google Scholar 

  3. Fox MR, Bredenoord AJ. Oesophageal high-resolution manometry: moving from research into clinical practice. Gut. 2008;57:405–23. doi:10.1136/gut.2007.127993.

    Article  CAS  PubMed  Google Scholar 

  4. Heatley M, Rose K, Weston C. The heart and oesophagus: intimate relations. Postgrad Med J. 2005;81:515–8. doi:10.1136/pgmj.2004.029074.

    Article  CAS  PubMed  Google Scholar 

  5. Wilmshurst PT. Tachyarrhythmias triggered by swallowing and belching. Heart. 1999;81:313–5.

    CAS  PubMed  Google Scholar 

  6. Stec S, Kulakowski P, Tarnowski W, Binda A. Radiofrequency ablation for premature ventricular complexes-induced dysphagia. Heart Rhythm. 2007;4:S11.

    Google Scholar 

  7. Stec S, Tarnowski W, Binda A, Kulakowski P. Videofluoroscopic modified barium swallow study for premature ventricular complexes-associated dysphagia. Circ Arrhythmia Electrophysiol. 2008;1:e1. doi:10.1161/CIRCEP.107.749903.

    Article  Google Scholar 

  8. Turcu A, Berthet F, Leveque L, Besancenot JF. Complete dysphagia during paroxysmal atrial fibrillation. Presse Med. 2002;31:935.

    CAS  PubMed  Google Scholar 

  9. Manfrini O, Bazzocchi G, Luati A, Borghi A, Monari P, Bugiardini R. Coronary spasm reflects inputs from adjacent esophageal system. Am J Physiol Heart Circ Physiol. 2006;290:2085–91. doi:10.1152/ajpheart.00925.2005.

    Article  CAS  Google Scholar 

  10. Cheng SB, Hayakawa T, Kuchiiwa S, Maeda S, Ito H, Seki M, et al. Evidence for the collateral innervation of the esophagus and the heart from neurons in the compact formation of the nucleus ambiguus of the rat. Brain Res. 1999;832:171–4. doi:10.1016/S0006-8993(99)01429-8.

    Article  CAS  PubMed  Google Scholar 

  11. Mitrani RD, Klein LS, Miles WM, Hackett FK, Burt RW, Wellman HN, et al. Regional cardiac sympathetic denervation in patients with ventricular tachycardia in the absence of coronary artery disease. J Am Coll Cardiol. 1993;22:1344–53.

    Article  CAS  PubMed  Google Scholar 

  12. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. J Am Coll Cardiol. 2006;48:e247–484. doi:10.1016/j.jacc.2006.07.010.

    Article  PubMed  Google Scholar 

  13. Stec S, Dabrowska M, Zaborska B, Bielicki P, Maskey-Warzechowska M, Tarnowski W, et al. Premature ventricular complex-induced chronic cough and cough syncope. Eur Respir J. 2007;30:391–4. doi:10.1183/09031936.00062606.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgment

This study was supported in part by research grant Nos. 501-2-1-10-72-04 and 501-1-1-28-46-08 from the Postgraduate Medical School (CMKP) in Warsaw, Poland.

Author information

Authors and Affiliations

  1. Division of Clinical Electrophysiology, Department of Cardiology, Grochowski Hospital, Postgraduate Medical School, Grenadierow 51/59 Street, 04-073, Warsaw, Poland

    Sebastian Stec, Katarzyna Kalin & Piotr Kulakowski

  2. Department of Endoscopy and Functional Tests of Digestive Tract, Orlowski’s Hospital, Postgraduate Medical School, Warsaw, Poland

    Wieslaw Tarnowski

  3. Department of General and Oncological Surgery, Grochowski Hospital, Warsaw, Poland

    Krzysztof Sikora

Authors
  1. Sebastian Stec
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wieslaw Tarnowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katarzyna Kalin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Krzysztof Sikora
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Piotr Kulakowski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sebastian Stec.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stec, S., Tarnowski, W., Kalin, K. et al. High-Resolution Esophageal Manometry with ECG Monitoring for Management of Premature Ventricular Complexes-Associated Dysphagia. Dysphagia 25, 66–69 (2010). https://doi.org/10.1007/s00455-009-9231-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-009-9231-2

Keywords

Search

Navigation