Transesophageal electrophysiologic study in children and young patients

Transesophageal electrophysiologic study (TEEPS) is a semi-invasive method of atrial stimulation and recording. The aim of the study was to report our experience with TEEPS in children and young adults. A total of 153 TEEPS were performed in 147 consecutive patients aged between 26 days to 26 years (mean 9.8 years) with the following indications: evaluation of symptoms that may be signs of any arrhythmias in 89 procedures (Group A), risk assessment of Wolff-Parkinson-White syndrome (WPW) in 17 procedures (Group B), determination of the mechanism of previously detected or ongoing tachycardia on ECG or Holter monitoring in 22 procedures (Group C), assessment of antiarrhythmic therapy effectiveness in 17 procedures (Group D), and follow-up of radiofrequency ablation procedure (RFA) in 8 procedures (Group E). A similar pacing protocol was performed for induction of tachycardia in each patient. Tachycardia was induced in a total of 72 procedures (72/153, 47%): 32/89 (36%) in Group A, 13/17 (76.5%) in Group B, 12/22 (54.5%) in Group C, 12/17 (70.6%) in Group D and 3/8 (37.5%) in Group E. In Group A, the ventriculoatrial (VA) interval of inducible tachycardia was found to be shorter than 70 msec in 16/32 (50%) and longer than 70 msec in 12/32 (37.5%) patients and these patients were diagnosed as having atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT), respectively. In this group, 1 atrial tachycardia, 2 junctional ectopic tachycardia, 1 sinus node reentrant tachycardia and 1 permanent junctional reciprocating tachycardia (PJRT) were also diagnosed. In conclusion, transesophageal atrial stimulation is a valuable tool in the initial evaluation of patients with symptoms possibly related with arrhythmia or in the management of patients who have any arrhythmia.