Deglutition-Induced Atrial Fibrillation in a Previously Healthy Adult Male: A Rare Trigger Unmasked After Medication Discontinuation

We report a rare case of swallowing-induced paroxysmal atrial fibrillation (AF) in a previously healthy 50-year-old male. Initially diagnosed with paroxysmal AF and successfully managed on flecainide and bisoprolol, the patient became asymptomatic, and his Holter monitor prior to the latest admission showed he maintained sinus rhythm. However, after discontinuation of antiarrhythmic therapy, he presented with recurrent palpitations. Continuous telemetry monitoring during readmission revealed episodes of AF triggered by swallowing liquids, resolving shortly thereafter. Investigations ruled out structural heart disease, thyroid dysfunction, and electrolyte abnormalities. This case highlights the importance of recognizing atypical triggers of AF.