Electropharmacological testing by transoesophageal atrial pacing in inducible supraventricular tachyarrhythmias. A good approach for selection of long-term anti-arrhythmic therapy

Sixty-eight patients with disabling episodes of inducible supraventricular tachyarrhythmia were tested electropharmacologically by transoesophageal atrial pacing. Using this technique we induced clinical arrhythmia in 67 (98.5%); 26 (38.8%) had a reciprocating tachycardia due to AV node reentry and...

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Bibliographic Details
Published inEuropean heart journal Vol. 13; no. 6; p. 763
Main Authors Guarnerio, M, Furlanello, F, Vergara, G, Inama, G, Del Greco, M, Accardi, R, Dallago, M
Format Journal Article
LanguageEnglish
Published England 01.06.1992
Subjects
Administration, Oral
Adolescent
Adult
Aged
Anti-Arrhythmia Agents - administration & dosage
Anti-Arrhythmia Agents - therapeutic use
Cardiac Pacing, Artificial
Drug Combinations
Esophagus
Female
Heart Atria - physiopathology
Humans
Injections, Intravenous
Male
Middle Aged
Tachycardia, Supraventricular - drug therapy
Tachycardia, Supraventricular - physiopathology
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Summary:Sixty-eight patients with disabling episodes of inducible supraventricular tachyarrhythmia were tested electropharmacologically by transoesophageal atrial pacing. Using this technique we induced clinical arrhythmia in 67 (98.5%); 26 (38.8%) had a reciprocating tachycardia due to AV node reentry and 41 (61.2%) a by-pass tract. In the latter we induced a reciprocating tachycardia in 12 (29.3%), atrial fibrillation in 25 (36.5%) and both in 14 (34.2%). We then performed an anti-arrhythmic drug test and a transoesophageal reevaluation either after acute intravenous drug administration or during oral steady state. Altogether we tested 111 drugs or a combination of drugs before the results were considered positive; all patients tolerated the procedure well and were discharged with the drug or combination of drugs judged effective. At follow-up of 16.6 +/- 8.5 months, 42 patients (62.7%) were symptom-free, 17 (25.3%) had minor and non-disabling relapses, six (9%) stopped the drug because of inefficacy (1-1.5%) or side effects (5-7.5%); two (3%) dropped out. We conclude that electropharmacological testing with transoesophageal pacing constitutes a very good approach for inducible supraventricular tachyarrhythmias: it permits selection of optimal long-term anti-arrhythmic treatment and is well tolerated, only slightly invasive and without adverse effects.
ISSN:0195-668X
1522-9645