Swallow syncope

Swallow syncope is a rare disorder caused by hypersensitive vagotonic reflex in response to deglutition. A 26-year-old man complained of recurrent light-headedness and near syncope on swallowing was hospitalized for monitoring and evaluation. Continuous electro-cardiographic and invasive arterial pressure monitoring showed ingestion of a solid meal evoked lightheadedness and complete AV block without an escape rhythm that lasted for 5.6 seconds. This patient received a Medtronic Kappa (401B) DDDR pacemaker with the rate drop feature. The patient has remained asymptomatic on follow-up for the past 2 years.