This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stec, S. Articles by Kulakowski, P. Search for Related Content PubMed PubMed Citation Articles by Stec, S. Articles by Kulakowski, P. Related Collections Arrhythmias, clinical electrophysiology, drugs Electrophysiology Ablation/ICD/surgery Cardiovascular imaging agents/Techniques

Images and Case Reports in Arrhythmia and Electrophysiology

Videofluoroscopic Modified Barium Swallow Study for Premature Ventricular Complexes–Associated Dysphagia

Sebastian Stec, MD; Wieslaw Tarnowski, MD, PhD; Artur Binda, MD and Piotr Kulakowski, MD, PhD, FESC

From the Department of Cardiology, Grochowski Hospital, Postgraduate Medical School (S.S., P.K.) and the Department of General and Gastroenterological Surgery, Orlowski’s Hospital, Postgraduate Medical School (W.T., A.B.), Warsaw, Poland.

Correspondence to Sebastian Stec, MD, Postgraduate Medical School, Department of Cardiology, Grochowski Hospital, Grenadierow 51/59 St, 04–073 Warsaw, Poland. E-mail smstec@wp.pl

An extract of the first 250 words of the full text is provided, because this article has no abstract.

An 18-year-old white female with a body mass index of 28 kg/m² presented with a 6-month history of intermittent esophageal dysphagia, dizziness, and heavy vomiting associated with frequent premature ventricular complexes (PVCs). Her echocardiogram was normal, and serial 24-hour ambulatory Holter monitoring documented between 100 and 5000 monomorphic PVCs. A 12-lead ECG obtained during an emergency department visit revealed monomorphic single PVC, as well as pairs and triplets with inferior axis and left bundle-branch block pattern. Upper endoscopy and chest x-ray did not reveal any pathologies. Videofluoroscopic modified barium swallow study with simultaneous ECG monitoring was performed with the patient in a supine position in the catheterization laboratory. The patient was asked to swallow 15 mL of barium, and subsequently fluoroscopy was performed twice, first during sinus rhythm and then during frequent PVC. During sinus rhythm, no symptoms of dysphagia and no abnormalities in barium passage through the esophagus were documented (Movie I). During frequent PVC, however, the patient reported difficulty swallowing and intraesophageal reflux, and prolonged barium deposits in the upper esophagus were documented (Movie II). In esophageal manometry during sinus rhythm, no significant abnormalities were found; however, during frequent PVC, esophageal spasm and abnormal motility were documented. Motility disorders ("corkscrew and nutcracker esophagus") were excluded with manometry and follow-up. After ineffective treatment with metoprolol, propafenone, and verapamil, the patient was referred for radiofrequency (RF) ablation. Coronary angiography excluded coronary artery abnormalities. Intracardiac mapping catheterization documented the earliest ventricular activation in the left aortic cusp. Local potentials preceded the . . . [Full Text of this Article]

This article has been cited by other articles:

				S. M. Stec, E. M. Grabczak, P. Bielicki, B. Zaborska, R. Krenke, T. Krynski, M. Dabrowska, J. Domagala-Kulawik, A. Domeracka-Kolodziej, A. Sikorska, et al. Diagnosis and Management of Premature Ventricular Complexes-Associated Chronic Cough Chest, June 1, 2009; 135(6): 1535 - 1541. [Abstract] [Full Text] [PDF]