Symptomatic spontaneous paroxysmal AV nodal block due to localized hyperresponsiveness of the AV node to vagotonic reflexes

Abnormal Esophagocardiac Inhibitory Reflex in Patients with Diffuse Esophageal Spasm

“…This effect resembles that obtained by an in crease in vagal tone which inhibits both sinus and atrio ventricular node activity, and is characterized by a pre dominance of heart rate slowing, while atrioventricular conduction disturbances are not seen [22], The finding of significantly higher than normal wave amplitude and duration observed both after dry and solid swallows in patients with DES could suggest that the decrease in heart rate is related to the wave strength stimulating the intraparietal tensoreceptors more intensely. However, this hy pothesis is contradicted by the fact that a similarly intense stimulation with a balloon inflated at 100 mg Hg in botl groups induces a higher decrease in heart rate in patient!…”

Paroxysmal atrioventricular block: clinical experience with 20 patients

“…It is relatively rare and has been previously described in association with bradycardia and tachycardia [3 -5], coronary angiography [6], vomiting [7], swallowing [8 -11], coughing [12,13], carotid sinus massage [14,15], and head-up tilt table testing [16,17]. The level of block is at either the AV node 6 or the His-Purkinje system [2,18].…”

Complete atrioventricular block in a patient with acute cholecystitis: a case of cardio-biliary reflex?

“…According to this, vagally mediated AV blocks were observed in different circumstances: during left vagus nerve stimulation for epilepsy, or induced by carotid sinus pressure, by gastric dilatation, and by deep inspiration. The authors of the latter presumed a syndrome reflecting hyperresponsiveness of the AV node to vagotonic reflexes producing recurrent syncope [4]. Our previously healthy patient experienced three episodes of syncope.…”