Esophageal Electrocardiography

Atrio-ventricular conduction in patients with permanent right-ventricular stimulation. I. Possibilities of evaluation by the method of transesophageal electrocardiogram.

Ciemniewski Z, Zajac T, Kargul W, Giec L.Kardiol Pol 1990 Feb;33(2):73-8. We analyzed 214 patients with permanent, VVI mode stimulation divided in 5 groups. Group I 89 patients (pts) with sick sinus syndrome (sss) (mean age 60 +/- 14 yrs), group II 21 pts with sss and atrioventricular (a-v) conduction disturbances (mean age 54 +/- 19 yrs), group III 72 pts with a-v block, but without intraventricular conduction disturbances (mean age 68 +/- 11 yrs), group IV 20 pts with a-v block and registered bundle branch block (mean age 67 +/- 7) and group V 12 pts after His bundle ablation (mean age 51 +/- 20 yrs). In all pts we recorded leads I, II, III, V1, V6 and oesophageal (oe) on Mingophon 7 (Siemens-Elema) with paper speed 50 mm/s. All recordings were performed during basic and magnetic rate of the pulse generator. We could analyzed ventriculo-atrial (v-a) conduction in group I-IV respectively in 89.9%, 95.3%, 84.7%, 100%, 83.3% and in all population in 89.2% cases. In 23 pts (10.8%) we could not analyzed v-a conduction due to atrial flutter or fibrillation. V-a conduction was present in groups I-IV in 61.2%, 35%, 21.4%, 45% and 10% cases respectively. Conclusions: 1. In group patients with sick sinus syndrome and VVI stimulation ventriculo-atrial conduction was recorded in most cases. 2. Ventriculo-atrial conduction was recorded in part of the population with atrio-ventricular block. 3. Frequency of ventriculo-atrial conduction phenomenon is dependent on degree of a-v block. 4. Transesophageal recording of ventriculo-atrial conduction phenomenon in patients with implantable VVI pacemaker is simple, noninvasive and useful method for clinical practice.

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