Question: I believe I suffer from Roemheld Syndrome but most doctors I have consulted do not recognize this. Are there any doctors on your site that can advise me on this topic?

Thank you for your reply. I understand why you believe the excessive sympathetic response by the heart should be seen as the problem and treated with a beta blocker. I respectfully believe the root cause of the problem is the inappropriate nature of the vagal reflex after each swallow. The excessive sympathetic response should be seen as an expected response by an otherwise healthy cardiac system. Many others suffering with Roemheld Syndrome report negative reactions to beta blockers. I have been dealing with this for quite some time now and feel like I am a living laboratory. This offers me unique insight and understanding about this problem. I was given beta blockers in the past and they did not improve my situation. The only thing that did was the PPI medication which speaks to some type of inflammation that is causing all this. I am going to try and make contact with the electrophysiologist that did my EP study many years ago and see if a followup EP study could perhaps show how the vagus nerve is causing this problem. Perhaps an ablation of those inputs could help. I did come across one example of someone who had exactly the same issue and an ablation was able to solve her problem.
The literature is ripe with examples of people stating that hiatal hernias have produced this syndrome. That is another avenue I would like to pursue. Having said all that, do you know of any medications or procedures that could reduce the inflammation of a vagus nerve? As crazy as this sounds, when I aggressively rub the xiphoid process area as I swallow, I can directly reduce the affect on my heart rhythm. Another thing I have found successful is to drink a glass of warm water and then do repeated drops from my toes to my heals. Immediately following these repeated drops, the swallowing trigger stops for a short period of time. This happens every time and is measurable on EKG. This makes me believe that a hiatal hernia may be part of this.
I look forward to your response.

Thank you Dr. XXXXXXX for your response. I wish to inquire further with your suggested us of 1.25 mg Nebilet to control this problem. Are you suggesting that this medication will prevent the swallowing induced bradycardia from happening? If so, I would welcome its use. If not, I am not clear as to why I would take it. My main issue is the fact that each and every time I swallow I have a terrible disruption to my heart rhythm. As I said before, to have gone for the past 20 years completely free of this only makes me believe strongly that some type of inflammation needs to be corrected. I am able to engage in high intensity exercise when this is not happening. My heart has been put to the test climbing mountains, paddling rivers, hiking and biking around the world. I know the heart is fine and this has been proven with countless investigations. I need to find the answer as to why my vagus nerve wants to slow the heart inappropriately when it shouldn't (during exercise).
I will be seeing a cardiologist soon. Can you suggest any other ideas or things to test? I still hope there is a simple mechanical explanation for this. As an example, just prior to all this starting 25 years ago, I was involved in very heavy weight training. This might have caused some initial damage (sliding hiatal hernia).
I look forward to hearing your thoughts.

Thank you for your thoughts. I will try to contact if I learn anything significant. Im not if there is such a mechanism to contact you once this discussion is closed.
Take care