Combined use of left atrial transesophageal pacing and cordarone in atrialflutter

Aim. To investigate the effectiveness of superfrequent transesophageal left atrial stimulation (TLAS) and ifs combination with cordarone in management of atrial flutter (AF). Materials and methods. 650 patients with paroxysmal AF underwent TLAS: The paroxysm duration varied from 1 hour to 1 month. In 312 patients TLAS was p erformed prior to treatment with antiarrhythmic drugs (group 1), in 338 pat ients - after intravenous administration of cordarone (group 2). Results. Superfrequent TLAS has restored sinus rhythm (SR) in 85(27.2%) and 169(50%) patients of groups 1 and 2 respectively (p < 0.001). TLAS promote d conversion of AF in atrial fibrillation (AFi) in 185(59.3%) and 159(47.1% ) patients of groups I and 2, respectively (p < 0.01). Moreover, SR recover ed 24-48 hours after TLAS in 87(27.9%) and 64(18.9%) patients of groups 1 a nd 2, respectively (p < 0.01). Sinus rhythm recovered in a total of 172(55. 1%) and 233(69.0%) patients, AI; was converted to AFi in a total of 88(31.4 %) and 95(28.1%) patients (p > 0.05) of groups 1 and 2, respectively. TLAS was uneffective in 42(13.5%) and 10(2.9%) patients of groups 1 and 2, respe ctively. Conclusion. Super-frequent TLAS is a highly effective and non-invasive moda lity in the treatment of paroxysmal AF. It promotes recovery of SR. In same patients TLAS induces AFi which is more controllable by medication as rega rds the heart rate. Cordarone contributes to the response to TLAS in patien ts with paroxysmal AF.