Transesophageal Cardioversion and Defibrillation

The transesophageal approach to the heart in electrotherapy of trachycardiac arrhythmias. I. Transesophageal electrostimulation procedure.

Volkmann H, Paliege R, Kuhnert H, Meier F, Sauser M. Z Gesamte Inn Med 1981; 36(23):903-8. Transoesophageal electrostimulation techniques were used in 124 cases of different tachycardiac disturbances of rhythm. By means of highly frequent transoesophageal atrial stimulation we succeeded in transformating into sinus rhythm in 46% of the patients with atrial flutter, in 29% of the cases with atrial tachycardias and in 75% of the patients with av-junctional tachycardias. At least atrial fibrillation (with decrease of the ventricular frequency) could be induced in 48% in pre-existing auricular flutter, in 38% in auricular tachycardias and in 15% in av-junctional atrial (partial success of therapy). Sinus tachycardias, atrial fibrillation and ventricular tachycardias could practically not be influenced by highly frequent transoesophageal atrial stimulation. Moreover, for the first time the techniques of the doubled or coupled atrial stimulation, in 2 cases also ventricular stimulations with higher frequency were tested on transoesophageal way and were introduced into the treatment of tachycardiac disturbances of rhythm. The therapeutic results of transoesophageal electrostimulation techniques seem to be comparable entirely with those of intracardiac stimulations, in which cases the non-invasive and uncomplicated techniques are accessible also to institutions without possibilities of heart catheterization.

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