Role of Transesophageal Pacing in Evaluation of Palpitation in Infants and Children

ABSTRACT

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.