Transesophageal atrial pacing in patients with suspected arrhythmia recurrence after its nonpharmacological treatment

Transesophageal pacing (TAP), a semi-invasive, no X-ray method of electroph ysiological study (EPS) is shorter than classical EPS. Our aim was to show usefulness of TAP in patients with suspected supraventricular tachycardia r ecurrence after its nonpharmacological treatment. Thirty five TAP were performed in 34 patients (14M; 37+/- 17 yrs): 20 - ear ly follow-up EPS (<2 weeks after ablation), 12 - because of heart palpitati ons 1 mo -5 yrs after RF ablation (ARF), two - 4-8 yrs after surgical acces sory pathway (AP) dissection, one - after surgery and ARF. Twenty two patie nts were after atrionodal reentrant tachycardia (ANRT) ARF (one with AP dis section, 2 - AP ARF, one - atrial flutter ARF), 3 pts after "Mahaim fibers" , 5 - Kent bundle ARF (one with DDD pacemaker). ANRT was induced in four patients: 1. Three days after "Mahaim fibers" ARF in pt with "jump" without ANRT inducible before and just after ARF; 2-3. Th ree days and two months after slow pathway and AP ARF; 4. Four years after slow pathway ARF and AP dissection. In one pt, palpitations were because of pacemaker atrial lead undersensing during atrial extra beats (AB), in two other - frequent AB. In others there was no arrhythmia during TAP - one had recurrence of ANRT inducible only with ventricular pacing. Conclusion: 1. Complex arrhythmia substrate seems to be the risk factor of ANRT recurre nce. TAP is a useful method in diagnosis of this phenomenon. 1. TAP is useful diagnostic method in patients with palpitations after nonp harmacological treatment of supraventricular arrhythmias.