Analysis of efficacy and safety in paroxysmal supraventricular tachycardia by transesophageal atrial pacing

Objective: To summarize and analyze the efficacy and safety in 238 patients with paroxysmal supraventricular tachycardia(PSVT) by transesophageal atrial pacing(TEAP).Methods: Heart multifuctionnal pacing stimulator,together with underdrive pacing(10-30 bpm lower than the rate of PSVT)→overdrive pacing(30-50 bpm higher than the rate of PSVT) → sudden pacing(40% higher than the rate of PSVT) were used to terminate PSVT by turn.At the same time all the instant electrocardiograms(ECG) were observed at least 10 seconds after the end of PSVT.If atrial fibrillation appeared,these cases were kept on observing till transformation.Results: Among 238 cases who were given underdrive pacing,32 cases were successful,the successful rate was 13.4%;206 cases were given overdrive pacing and 173 cases were successful,the successful rate was 83.9%;28 cases were given sudden pacing and 21 cases were successful,the successful rate was 75.0%,the total effective rate was 95.0%(226/238).OF all the instant ECG after the end of PSVT,there were 185 cases of normality(77.7%),5 cases of long P-R interval(2.1%),8 cases of atrial fibrillation(3.4%),2 cases of junctional escape beat(0.8%),5 cases of long pause over 1 500 seconds(2.1%),5 cases of single ventricular premature beat(2.1%),6 cases of ventricular premature beat couplets(2.5%) and 5 cases of transient ventricular tachycardia(2.1%).No patient had been given special treatment except that one had been given atrial pacing of 72 bpm,who had a long pause of 3.2 seconds.Conclusion: It is safe and effective to terminate PSVT by TEAP,which can be the preferred method for reentrant tachycardia.