TECHNICAL ASPECTS OF DECREASE IN DISCOMFO RT CAUSED BY TRANSESOPHAGEAL PACING OF THE HEART

Advantages of diagnostic transesophageal cardiac pacing over invasive atrial stimulation caused increased demand for transesophageal pacemak ers. At present more than 10 models are in use. But not all of them pr ovide necessary level of comfort for the patient. Quantitative evaluat ion of perception of discomfort is based on statistical measurements o f the patients sensitivity to changes in amplitude of impulses at the level of atrial pacing threshold. Discomfort for the patient can be le ssened by optimal choice of parameters of impulses, e.g. impulse durat ion 10 msec and downslope of Impulse peak 20 -40%. Selection of approp riate electrode, improvement of skill of its placement allows to decre ase atrial stimulation threshold by 5 - 7 v. Ventricular stimulation t hreshold can be lowered to a mean of 18 v by pacing through the stomac h with a specially designed electrode.