Greeley WJ; Reves JG. Duke University Med Ctr. Anesthesiology, Feb 1988, 68(2) p282-5. Cardiac dysrhythmias occur frequently in pediatric patients with congenital heart defects during general anesthesia and may cause hemodynamic instability. Urgent treatment of hemodynamically significant dysrhythmias in children during surgery heretofore has required antiarrhythmic therapy where efficacy is unpredictable. Alternatively, emergency transvenous cardiac pacing, which is highly invasive and technically difficult, is possible. We report 2 cases where transesophageal atrial pacing was successfully performed in pediatric surgical patients in the treatment of hemodynamically signficant dysrhythmias during general anesthesia.