A novel method for reducing pain sensation at transesophageal atrial stimulation

Transesophageal atrial stimulation (TAS) is widely used in evaluation and treatment of supraventricular arrhythmias. It can yield important information in most situations, where invasive atrial stimulation is usually done, but is safe, rapid, inexpensive and can often be performed in an outpatient setting. However, in clinical practice TAS pacing usually causes patients some degree of discomfort and/or pain. The aim of the study was to evaluate the possibility and methods to obtain successful atrial capture using multiple electrical pulses in order to reduce pain sensation during the procedure. The study was performed in 17 patients aged 22 to 54 years, special experimental arrangement was used. We elaborated a novel method of combining very short electric pulses (splitting the impulse) from different locations which resulted in desired current density and pulse length in target tissue. As the result the stimulation could be less painful for patient than routinely used single 10ms current pulse.