[Clinical use of electrical atrial stimulation]

Electric auricle stimulation (EAS) was realized in a total of 77 patients. In 60 of the patients EAS was performed as a hypoxic test (step-wise increase of heart rate, with ECG registration and in many of the cases -- registration of certain indices of general and intracardial hemodynamics) with a view to precise diagnosis of ischemic heart disease and assessment of myocardial contraction function. In 91 per cent of the patients with stenosed coronary pathology on coronarogram, the symptoms of coronary insufficiency were positive (pain attack, ECG changes via ischemic type and/or deterioration of the myocardial functional curve) with the aid of EAS. Various correlations were established between the manifestations of coronary insufficiency and the deterioration of the functional curve of left ventricle. Furthermore, in the majority of the cases, one way results, among the data of veloergometry, coronarography and EAS, were recorded. In some cases EAS provided additional data for coronary insufficiency with negative veloergometric test (7 patients) and negative coronarography (5 patients). EAS could be applied in the diagnostics of ischemic heart disease, and in a hemodynamic aspect, via EAS a myocardial loading is realized with a minimum change of cardiac index and aortic pressure. In 16 patients EAS was applied with a view to the investigation of the functional state of sinal node and heart conduction system. In 13 patients, data about the syndrome of morbid sinal node were found (pathologic time of sinal node restoration) or for a latent lesion of heart conduction system. In the other three patients the suspicion of syndrome of morbid sinal node was not confirmed. The data obtained contributed to the determination of the therapeutic approach of those patients. In 5 patients a high frequency auricle electrostimulation was applied successfully in the interruption of paroxysms of supraventricular tachycardia. EAS was concluded, on the base of the data obtained, to be appropraite for application and precise diagnosis of ischemic heart disease, as well as in the studies on sinal node state and heart conduction system. In some rhythm disturbances, resistant to medicamentosus treatment, the electric auricle stimulation could prove a valuable therapeutic method.