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[Study of sinus function and nodal conduction using transesophageal recordings].

J Y Le Heuzey, G Khaznadar, L Guize

    Archives Des Maladies Du Coeur Et Des Vaisseaux
    |January 1, 1987
    PubMed
    Summary

    Transoesophageal pacing can reliably assess sinus node function and A-V nodal conduction, comparable to endocavitary methods. Minor, temporary tachycardia occurs, but key electrophysiological parameters remain consistent.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Devices

    Background:

    • Transoesophageal pacing is used for supraventricular tachycardias and accessory pathway assessment.
    • Its utility for sinus node and A-V nodal conduction studies is proposed.
    • Potential for vago-sympathetic tone modification and discomfort requires investigation.

    Purpose of the Study:

    • To evaluate if transoesophageal pacing alters vago-sympathetic tone.
    • To compare transoesophageal pacing results with endocavitary pacing.
    • To assess transoesophageal pacing's reliability for sinus node and A-V nodal function.

    Main Methods:

    • Compared endocavitary and transoesophageal pacing in 20 patients.
    • Measured sino-atrial conduction time (SACT), sinus node recovery time (SNRT), Wenckebach's point, and nodal refractory periods.

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  • Utilized pacing parameters: 21.2 +/- 4.5 V tension, 16 msec duration, 30 mm interelectrode spacing.

    • Main Results:

    • A slight, transient tachycardia was observed post-oesophageal lead insertion (p<0.01).
    • A-V nodal conduction parameters showed no significant difference and strong correlation (Wenckebach's point r=0.94).
    • Sinus node function parameters showed no significant difference when oesophago-atrial delay was accounted for; corrected SNRT correlated well (r=0.92).

    Conclusions:

    • Transoesophageal pacing is a viable alternative to endocavitary pacing for A-V nodal conduction assessment.
    • With adjustments for oesophago-atrial delay, it reliably assesses sinus node function.
    • The method is safe, with only minor, transient physiological effects.