Non-Contact Three-Dimensional Mapping and Ablation of Swallowing-Induced Atrial Tachyarrhythmias: Two Case Reports


  • Manuscript received 10 January 2007; Revised manuscript received 21 February 2007; Accepted for publication 26 February 2007.

Address for correspondence: Hiroshi Tada, M.D., Division of Cardiology, University of Michigan Hospitals, TC B1 D140, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0311, USA. Fax: +1-(734) 936-7026; E-mail:


We describe two cases of swallowing-induced tachyarrhythmias that were cured by radiofrequency ablation (RFCA) using a non-contact mapping system (NCMS). In both patients, tachyarrhythmias occurred during swallowing solids and liquids, and mapping and ablation of the arrhythmia using the NCMS was attempted during swallowing a rice ball. During a premature atrial contraction shortly after the swallow, the earliest endocardial breakthrough occurred at the right superior pulmonary vein (PV) ostium in Case 1 and at the left superior PV ostium and postero-inferior right atrium in Case 2. Guided by the NCMS catheter navigation system, the ablation catheter was easily and precisely positioned at a site where the earliest endocardial breakthrough occurred. RFCA at that site resulted in success and no recurrence or complications occurred during the follow-up in either patient.