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To evaluate the clinical value of transesophageal cardiac pacing.
A cohort of 60 patients of tachycardia with transesophageal cardiac pacing in People's Liberation Army No. 252 Hospital from July 2015 to May 2016 was studied. The clinical data were retrospectively analyzed.
When tachycardia was induced or terminated by transesophageal cardiac pacing, 48 patients with supraventricular tachycardia (SVT)were found, of which 32 cases were diagnosed primarily as atrioventricular nodal reentrant tachycardia (AVNRT) (slow-fast) type, and 1case with AVNRT (slow-fast) type was found combined with paroxysmal atrial fibrillation. Besides, 5 cases were diagnosed primarily as AVNRT (fast-slow) type in the 48 patients, but no significant jump occurred with pacing of S1S2 kickback, which made atrioventricular reentrant tachycardia(AVRT) mistaken, then AVNRT (fast-slow) type was confirmed by invasive electrophysiological examination. 7 cases of A type WPW syndrome and 4 cases of B type WPW syndrome combined with SVT can be all induced by pacing. 3 cases of atrial tachycardia were induced, of which 2 cases were induced atrial fibrillation. 2 cases of atrial flutter were found by pacing. 5 patients failed to induce tachycardia during pacing. The reasons were followed: 1. Palpitations of the patient maybe were not caused by supraventricular tachycardia, atrial tachycardia and others; 2. Patients may have taken anti-arrhythmic drugs in a week; 3. Tachyarrhythmias with fewer episodes, short duration, may not be induced easily by pacing. In addition, 2 cases of pharyngitis failed to put electrode into the esophagus.
Transesophageal cardiac pacing has a therapeutic effect, and can be used as a powerful tool for the initial diagnosis of tachyarrhythmias, gradually becoming an essential preoperative examination of cardiac ablation. However, this examination has limitation of discerning the certain types of tachycardia.