Improved transesophageal recording and stimulation utilizing a new quadripolar lead configuration

Transesophageal pacing and recording are valuable techniques in the diagnosis and treatment of patients with arrhythmias. Bipolar pacing with bipolar catheters has been effective, but recording from the same electrodes is not possible during and immediately following pacing. We utilized a fine no. 4 French quadripolar catheter in 21 subjects to stimulate the atrium and record atrial electrical activity simultaneously. Pacing characteristics were equivalent to previously used bipolar catheters and recording was markedly enhanced. Bipolar atrial electrograms could be recorded either during pacing or at the first atrial depolarization following pacing in all patients. Thus, this quadripolar pacing lead improves the diagnostic value of studies involving transesophageal atrial pacing and recording.