Swallow Syncope Associated with Complete Atrioventricular Block in an Adolescent

We describe a 16-year-old female with a history of swallowing-induced syncope. The physical examination, ECG, echocardiography, barium swallow test, and thyroid function tests were within normal limits. The ambulatory ECG revealed intermittent complete atrioventricular block only associated with swallowing. There was also intermittent first-degree atrioventricular block not related to eating. An electrophysiologic study was performed during the implantation of a single-chamber transvenous ventricular pacemaker. There was mild atrioventricular nodal conduction disturbance with a His–ventricular interval of 70 msec and Wenckebach cycle length of 420 msec. During 1 year follow-up, the patient remained asymptomatic.