Transesophageal Electrophysiology

Diagnostic transesophageal atrial stimulation as a sinus node function test. I. Normal values and comparison with right atrial stimulation.

Volkmann H, Paliege R. Z Gesamte Inn Med 1981 May 1;36(9):287-94. For the non-invasive functional analysis of the sinus node diagnostic transoesophageal atrial stimulations were performed. By means of transoesophageal premature individual stimulation we succeeded in a calculation of the so-called sinuatrial conduction time in 112 of 118 normal persons (ESACT = 103 +/- 23.5 ms). In comparison to the results in right-atrial stimulation the transoesophageally established times were 20 to 30 ms longer. By means of transoesophageal atrial stimulation with higher frequency in 64 healthy test persons the recreation time of the sinus node was determined in 64 healthy test persons (ESNRT = 968 +/- 218 ms). Taking into consideration the double standard deviation in an upper limit of 1,400 ms was the result which corresponds to the limit in intraatrial stimulation. In the direct comparison of the transoesophageal and right-atrial stimulation technique in patients with and without syndrome of the sinus node for the sinuatrial conduction time (r = 0.81, n = 51) as well as for the recreation time of the sinus node (r = 0.90, n = 36) relatively good correspondences were found. In the transoesophageal stimulation, however, the larger distance of the place of stimulation from the marginal area of the sinus node, the conduction of the impulse over the left to the right atrium as well as a possible vagal irritation are to be taken into consideration.

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