Transesophageal Pacing for Temporary Heart Rate Acceleration and Management of Hemodynamics

Transesophageal ventricular stimulation and ventricular tachycardia in the period before implantation of a cardioverter-defibrillator.

Pella J, Bodnar J, Stancak B, Misikoa S, Sedlak J, Cizmarik P. Pasteura Univerzity P. J. Safarika, Kosice. Vnitr Lek 1994 Oct;40(10):663-6. The administration of an implantable cardioverter-defibrillator (ICD) is the method of choice in life-threatening ventricular tachyarrhythmias. This effective non-pharmacological intervention was a great advance in the prevention of sudden cardiac death. As to ventricular tachycardias, relapsing ventricular tachycardias based on ischaemic alone need not influence ventricular tachycardia. The mechanism of ventricular tachycardia in ischaemic heart disease is reentry and therefore this arrhythmia can be terminated not only by a defibrillation discharge but also by antitachycardiac stimulation. Various types of antitachycardiac stimulation are part of modern types of ICD. Evidence of the effectiveness of antitachycardiac stimulation (electrophysiological examination) permits to use it also by the transoesophageal approach. This treatment can be very effective and we can thus overcome the period before the definite administration of an ICD, as indicated by the case described.

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