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Castro, José

Decoodt, Pierre

Verbeet, Thierry

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Verbeet, Thierry William

Castro-Rodriguez, José

DI-fusion

Transesophageal pacing: a versatile diagnostic and therapeutic tool.

Thierry Verbeet

José Castro

Pierre Decoodt

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Indian Pacing and Electrophysiology Journal

Transesophageal Pacing : a Versatile Diagnostic and Therapeutic Tool

Transesophageal atrial pacing is feasible because of the proximity between the oesophagus and the posterior aspect of the atria1. Atrial pacing is possible through the oesophagus in almost all patients and can yield important information in many arrhythmias where single site atrial pacing is of value. It is a cheap procedure. There is no need for X Rays or cathlab.

Technical considerations

            Transesophageal pacing and recording is done using specialized or non specialized catheters. There are two different lead types: 1) the pill electrode, connected to a flexible wire, that the patient swallows with water. This pill electrode necessitates patient collaboration. 2) a flexible catheter that can even be used in comatose or intubated patients.

            The pacing lead, in our cases a bipolar flexible catheter, is introduced into the oesophagus via the nares after local nose anesthesia with xylocaine spray. Sometimes throat anesthesia with the same spray is also performed. Xylocaine gel is used to lubricate the lead and the lead is introduced with guidewires in it in order to increase its stiffness. It is positioned into the oesophagus in order to record the posterior paraseptal atrial electrogram. There is a relationship between the site of maximal atrial amplitude and the lowest atrial pacing threshold. The optimal atrial pacing site is usually found around 40 cm from the nares. Bipolar or unipolar recordings can be made

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Transesophageal pacing : a versatile diagnostic and therapeutic tool

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DI-fusion

Directory of Open Access Journals

CogPrints Cognitive Sciences Eprint Archive