The diagnosis and management of supraventricular tachycardia by transesophageal cardiac stimulation and recording.

Abstract:

:Twenty-two consecutive patients underwent esophageal stimulation and recording for the diagnosis and management of supraventricular tachycardia. In 13 of these patients, the resting electrocardiogram was normal and in nine it showed pre-excitation. Of the 13 patients with a normal resting electrocardiogram, supraventricular tachycardia was initiated in all. Seven patients had a ventricular-to-atrial interval greater than 70 ms during supraventricular tachycardia suggesting the presence of a concealed accessory pathway, and six patients had a ventricular-to-atrial interval less than 70 ms during supraventricular tachycardia suggesting reentry within the atrioventricular node. Supraventricular tachycardia was initiated in four of nine patients with pre-excitation on the resting electrocardiogram and the accessory pathway was confirmed by a ventricular-to-atrial interval of greater than 70 ms during supraventricular tachycardia in these four patients. Atrial fibrillation was initiated in eight of the nine patients with pre-excitation on the resting electrocardiogram and the shortest R-R interval during atrial fibrillation was measured. The response to therapy was assessed in seven of these nine patients by further measurement of the shortest R-R interval during atrial fibrillation following treatment. Esophageal stimulation and recording provides a simple noninvasive procedure which can be utilized as a screening technique to identify patients with intranodal reentry and those with reentry utilizing an accessory pathway. Sequential assessment of the response to therapy, especially in those patients with pre-excitation, is of considerable value in treatment.

journal_name

Chest

journal_title

Chest

authors

Harte MT,Teo KK,Horgan JH

doi

10.1378/chest.93.2.339

subject

Has Abstract

pub_date

1988-02-01 00:00:00

pages

339-44

issue

2

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)30648-1

journal_volume

93

pub_type

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