Gag Reflex-Mediated Restoration of Sinus Rhythm during TEE Probe Insertion for Atrial Fibrillation: A Word of Caution

Zeid Nesheiwat; Marcel Ghanim; Joseph Eid; Neha Patel; Cameron Burmeister; Ehab Eltahawy

doi:10.1155/2020/6398196

Gag Reflex-Mediated Restoration of Sinus Rhythm during TEE Probe Insertion for Atrial Fibrillation: A Word of Caution

Case Rep Cardiol. 2020 Mar 2:2020:6398196. doi: 10.1155/2020/6398196. eCollection 2020.

Authors

Zeid Nesheiwat¹, Marcel Ghanim¹, Joseph Eid¹, Neha Patel¹, Cameron Burmeister¹, Ehab Eltahawy²

Affiliations

¹ Department of Internal Medicine, The University of Toledo Medical Center, Toledo, Ohio, USA.
² Department of Cardiology, The University of Toledo Medical Center, Toledo, Ohio, USA.

Abstract

It is recommended to attempt vagal maneuvers as initial therapy in various types of supraventricular tachycardia. While various forms of vagal techniques have been described, a gag reflex-mediated vagal technique, to the best of our knowledge, has not been. We present a case of gag reflex-mediated restoration of sinus rhythm in a patient with atrial fibrillation and rapid ventricular response upon transesophageal probe insertion. This case is unique due to the mechanism of vagally mediated cardioversion. It emphasizes that operators must be cautious regarding the risk of embolization of a potential thrombus from vagal-mediated cardioversion with unknown thrombus burden.

Publication types

Case Reports