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Objective To explore the clinical effect of transesophageal atrial pacing (TEAP) in the diagnosis of unexplained tachycardia in children. Methods The results of TEAP in 28 children with unexplained tachycardia diagnosed and treated from September 2017 to August 2019 were retrospectively analyzed and were compared with the intracardiac electrophysiological study. Results A total of 28 children (19 boys; 9 girls) with an average age of 10.8±3.7 years were treated with TEAP .There were 15 cases of atrioventricular reentrant tachycardia (AVR7)，8 cases of atrioventricular node reentrant tachycardia (AVNR7)，and 2 cases of intra-atrial reentrant tachycardia (IAR7)，and a diagnostic rate was 89.29% (25/28).The ectopic tachycardia was not induced in 3 cases. Intracardiac electrophysiological study (IEPS) was performed in 21 patients. One patient had no ectopic tachycardia induced by TEAP and was diagnosed with idiopathic right ventricular outflow tract ventricular tachycardia (RVOT-VT) by IEPS. One case of left bypass atrioventricular reentrant tachycardia (LP-AVRT) was misdiagnosed of atrial tachycardia (AT).The diagnosis results of other patients using IEPS were consistent with TEAP, and a coincidence rate was 90.48% (19/21). Conclusions The diagnosis of tachycardia by TEAP is highly consistent with the results of IEPS. TEAP is recommended for children with clinically unexplained tachycardia, so as to clarify the diagnosis and classification of tachycardia and provide evidence for further diagnosis and treatment.
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Objective To explore the value of transesophageal atrial pacing (TEAP) and temporary cardiac pacing in the treatment of acute intractable tachyarrhythmia in children. Method The clinical data of children with acute intractable tachyarrhythmia treated with TEAP (48 cases) or temporary cardiac pacing (6 cases) from January 2014 to December 2017 were retrospectively analyzed. Results In the 48 cases aged 1 day to 13 years (28 males and 20 females) treated with TEAP, 25 cases had paroxysmal supraventricular tachycardia, in which there were 15 cases of rapid atrial flutter, 5 cases of atrial tachycardia and 3 cases of left ventricular idiopathic bundle branch reentrant tachycardia. The rates of successful cardioversion to sinus rhythm through TEAP were 84％, 80％, 20％ and 100％ respectively. In the 6 cases aged 2 to 10 years (1 male and 5 females) treated with temporary cardiac pacing, there were 5 cases of fulminant myocarditis and 1 case of noncompaction of the ventricular myocardium and their conditions were well controlled after treatment. Conclusion TEAP and temporary cardiac pacing have good curative effect in the treatment of acute intractable tachyarrhythmia in children. However, temporary electricity therapy can only temporarily rectify the hemodynamic abnormality threatening the life of children, and active comprehensive treatment for the primary diseases should be carried out simultaneously.
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Objective To explore the value of transesophageal atrial pacing (TEAP) in assessing the mechanism of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The electrophysiological data of 50 children with PSVT who had undergone TEAP and, at a later stage, radio-frequency catheter ablation (RFCA) examination were retrospectively analyzed from January 2008 to December 2013. Results When using the intracardiac electrophysiological study (IEPS) as the diagnostic gold standard, the sensitivity of TEAP for atrioventricular nodal reentrant tachycardia (AVNRT), left accessory pathway (LAP) and right accessory pathway (RAP) was 92.9%, 83.1%and 90%respectively;the speciifcity was 86.4%, 100%and 95%respectively;the accuracy was 90%, 96%, and 94%respectively. The diagnostic accuracy of TEAP for AVNRT was 92.9%(26/28), the diagnosis accuracy for slow-fast AVNRT was 100%, but 2 cases of fast-slow AVNRT were both misdiagnosed as AVRT. The diagnostic accuracy of TEAP for AVRT was 86.4%(19/22) and 3 cases were misdiagnosed as slow-fast AVNRT. Conclusions TEAP has good clinical value in ifnding the mechanism of PSVT and its preliminarily location in children, but it has some limitations for some types of PSVT.
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Objective To evaluate the clinical application value of transesophageal atrial pacing (TEAP) combined with atropine load experiment in the diagnosis of the lesions of sinoatrial node and atrioventricular node.Methods One hundred and forty-four cases selected from the outpatient and hospitalized patients in the People's Hospital of Changji Hui Autonomous Prefecture from September 2009 to December 2012,who with dizziness, syncope and other clinical symptoms and electrocardiogram showe.TEAP combined with atropine load experiment were given to these patients.Results (1) The authors detected in all patients,83 cases (57.6％) were positive, among which, 48 cases (57.8％) male, 35 cases (42.2％) female.(2) The authors detected 57 cases(39.6％) non-increased vagus nerve tension cases in 83 positive cases,among which 33 cases (57.9％) male, 24 cases (42.1％) female;Among which 29 cases (20.1％) were sinoatrial node hypofunction, and 16 cases(55.2％) male;8 cases(5.6％) were atrioventricular node hypofunction,and 4 cases(50％) male;14 cases(9.7％) were double node hypofunction, and 10 cases (71.4％) male;6 cases (4.2％) were tachycardia-bradycardia syndrome, and 3 cases (50％) male;among which, a long interval of greater than 3 seconds appeared when we stimulate one 84 years old man with S1S1 stimulate way, immediately pressed protective pacemaker until his own sinus rhythm was restored, as a safety precaution, stoped further examination and classified him as sick sinus group.Conclusion Detect the common causes of slow sinus and atrioventricular block,such as the sinoatrial node dysfunction, atrioventricular node dysfunction, double node dysfunction and increased vagus nerve tension through TEAP combined with atropine load experiment.Consider that this methods have the best diagnostic value in decreasing its rate of false positivity,and should be used as a necessary check before implantation of pacemaker in such patients, suitable used in clinical, especially in basic general hospitals.
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Objective To identify the charactor of wide QRS complex tachycardia( WCT)throuGh transesophaGeal atrial pacinG( TEAP ). Methods TEAP and intracadiac electrophysioloGical examination infoamation of l2 cases WCT were collected and analyzed from January to February in 20l2 of Wuhan Asia Heart Hospital. Results Comparison of TEAP and intracadiac electrophysioloGical examination showed that l0 in l2 patients were match. Conclusion TEAP is a rapid and convenient method to diaGnose most WCT.
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PURPOSE: We intended to find out the role of transesophageal atrial pacing in evaluation of infants and children with palpitation of unknown origin. METHODS: We tried transesophageal atrial pacing study in 69 infants and children with palpitation, in whom tachycardia wasn't documented in electrocardiogram and reviewed retrospectively the records of transesophageal pacing and medical records of theses patients to find out the induction rate of tachycardia by transesophageal atrial pacing and the possible mechanism of tachycardia if induced. RESULTS: In 70.1% infants and children with palpitation, tachycardia was induced, so we could conclude that tachycaridia was the cause of palpitation in these cases. In most cases, tachycardia was induced by rapid atrial pacing, and in 21% by using isoproterenol. Tachycardia induction rate was higher in or =6-year-old children(P<0.05). In cases of the induced, we reviewed the mechanism of tachycardia. Of these induced tachycardias, 53.2% is atrioventricular reentry tachycardia, 34.0% were atrioventricular nodal reentry tachycardia, and 12.8% were idiopathic left ventricular tachycardia. Invasive electrophysiologic study was done to 10 patients of those induced. The results of electrophysiologic study and transesophageal pacing and recording were the same except for one patient. CONCLUSION: Transesophageal atrial pacing and recording is a less invasive, safe and useful method to find out the cause of palpitation and the mechanism of tachycardia in infants and children.
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Lactente , Criança , Masculino , Feminino , HumanosRESUMO
Objective To investigate the indications to use a temporary pacemaker for bifascicular block in perioperative period.Methods The treatment for 40 patients with heart bifascicular block and a special case were retrospectively studied.All cases,according to their disease history,clinical symptoms,physical ability and atrio-ventricular conduction ability,were divided into two groups:P group(prophylactic insertion of a temporary pacemaker) and N group(without inserting a pacemaker).During operation,we observed whether atrio-ventricular block occurs,the performance of pacemaker and atropine's therapeutic efficacy to bradycardia.Results Anesthesia was postponed in one case because of acute left bundle branch block(LBBB) and the patient died with severe myocardium damage soon after failed resuscitation.All other cases went through anesthesia and operation smoothly.Bradycardia and hypotension could be relieved somewhat by medication in operation,and no complete atrio-ventricular block developed.Conclusion There is no need inserting a temporary pacemaker for chronic bifascicular block if asymptomatic and no atrio-ventricular block.Transesophageal atrial pacing is an easy way to evaluate in quantification atrio-ventricular conduction ability.
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Objective To explore the causes of short P R interval syndrome.Methods 15 patients of short P R interval syndrome were tested with transesophageal atrial pacing (TEAP),and then the results and the parameters of TEAP were analyzed.Results The detection rates of dual atrioventricular nodal pathways(DAVNP),L G L syndrome and latent preexcitation syndrome were 66.67%(10/15),26.67%(4/15)and 6.67%(1/15)respectively.Conclusion The most common causes of short P R interval syndrome are DAVNP and the L G L syndrome
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The study group consisted of 50 normal children. The determination of Sinus node func- tions included SNRT, CSNRT, SNRTI, SACT, IHR and autonomic nervous system tone. The A-V conduction system function was evaluated by measurement of wenckeback point and 2:1 point of A-V conduction system. Each parameter was determined before and after com- bined autonomic blockade. Before combined blockade, the Wenckeback point and 2:1 point appeared at the HR of 175-220 bpm were 90% of the cases and 98% of the cases respectively, after combined block- ade, they were 98% of the cases and 100% of the cases respectively. It also showed the domi- nant vagus had effect on A-V node.