Transesophageal Electrophysiology

Diagnostic transesophageal atrial stimulation for sinus node function testing. II. Results in patients with and without sinus node syndrome.

Volkmann H, Paliege R. Z Gesamte Inn Med 1981 Feb 15;36(4):93-102. By means of transoesophageal atrial stimulation of higher frequency in patients with sinus node syndromes (n = 78) in about 60% of the cases a prolonged sinus node recovery time could be proved. After the end of the stimulation secondary stops appeared in about half of the patients, so that in 81% of the cases at least one pathological result was established. By means of premature individual transoesophageal stimulation (n = 99) in 2/3 of the patients with sinus node syndrome we contrived to perform a calculation of the sinuatrial conduction time. Half of all calculable values were above the normal. In 1/3 of the examined persons pathological stimulation patterns were found. Altogether 90% of the patients showed at least one pathological result, when apart from prolonged sinus node recovery times and sinuatrial conduction times at the same time secondary stops after serial stimulation with higher frequency and abnormal behaviour patterns of the post-extrasystolic stops after individual stimulation were taken into consideration. In patients with different cardiovascular diseases without clinical or electrocardiographic reference to a sinus node dysfunction in 25% of the cases at least one pathological result was found, in which case cannot be clarified, whether latent functional sinus node disturbances or falsely positive results are in question or not. Altogether the non-invasive transoesophageal stimulation technique leads to on principle diagnostic evidences of the same value as the up to now usual stimulation of the right atrium. Methodical problems which arise from the stimulation of the right atrium in transoesophageal approach are to be taken into consideration in the interpretation of the results.

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