吞嚥導致之心搏過速心律不整是相當罕見的現象，過去文獻約只有50幾例個案報告。本 文報告一位吞嚥引起陣發性心房顫動合併第二類B型神經心因性昏厥的案例。一位71歲女性 主訴間歇性心悸，常發生於夜間及用餐吞嚥時。心悸的症狀在走路活動之後會緩解，心悸時 心電圖記錄到陣發性心房顫動，患者有一次昏厥的病史。給予飲用常溫水可以很容易引發心 房顫動的短暫發作。傾斜床測試中，在給予舌下硝化甘油(Nitroglycerin) 後，誘發重複性心房 早期收縮，緊接著發生心跳休止達4.86秒。在吞嚥誘發心房顫動合併第二類B型神經心因性 昏厥的診斷下，經由雙腔節律器植入合併Propafenone 150mg 一天三次治療，病患的臨床症狀 得到良好控制，沒有再發生暈厥。

Swallowing-induced tachyarrhythmias is a rare phenomenon, with only over 50 cases reported in the literature. We reported a unique case of swallowing-induced paroxysmal atrial fibrillation(AF) associated with Type IIB neurocardiogenic syncope. A 71-year-old woman presented with intermittent palpitation happening mostly at night time and during meal when she swallowed food. The symptom of palpitation could be relieved by walking exercise. Paroxysmal atrial fibrillation was documented during palpitation. She also had an episode of syncope. Brief episodes of AF could be easily induced by drinking water in room temperature. Tilting table test results showed a very short duration of repetitive premature atrial contractions (PACs) followed by cardiac asystole up to 4.86 seconds after provocation with sublingual nitroglycerin. Under the diagnosis of swallowinginduced AF and Type IIB neurocardiogenic syncope, she was successfully treated with a DDDR pacemaker and oral propafenone 150mg three times a day. The clinical symptoms were under well control and there was no more syncope after treatment.