TRANSESOPHAGEAL ELECTROCARDIOGRAPHY AND P ACING IN INFANTS AND CHILDREN

In 33 infants and children (mean age 5 years) transesophageal electroc ardiography and pacing was performed for diagnosis and therapy of supr aventricular tachycardia (n = 17) and atrial flutter (n = 16). After s edation with diazepam or pethidin, a 9.5 F bipolar electrode catheter (interelectrode spacing 15 mm) was placed in the esophagus for recordi ng the atrial electrogram. Stimulation was performed with a pulse widt h of 2 ms and an amplitude of 12 to 20 mA. In all patients with suprav entricular tachycardia, the electrophysiological mechanisms could be e stablished (accessory pathway n = 14, AV-nodal reentry n = 1, PJRT n = 2). Supraventricular tachycardia was terminated by transesophageal pa cing in all 17 patients. Atrial flutter was successfully stopped in 13 of 16 patients (81%). No serious side effects were noted during the p rocedures. Transesophageal electrocardiography and pacing are very use ful for diagnosis and treatment of supraventricular tachycardia and at rial flutter in infants and children.