Analysis of the efficacy of transesophageal atrial pacing in the treatment of supraventricular tachycardia in newborns

Figures

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  Figure 1. Surface ECG and esophageal ECG synchronous recording of PSVT: lead EB (20 mm/mV), when tachycardia occurs RR interval 256 ms (234 bpm), RP' 104 ms, P'R 156 ms, suggestive of AVRT; S1S1 interval 333 ms (180 bpm), 6 burst stimuli, clearly visible atrial capture by the 2nd to 6th S1 stimuli (indicated by red arrow), followed by ventricular conduction, forming a trailing phenomenon, termination of tachycardia, and restoration of sinus rhythm.

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  Figure 2. Surface electrocardiogram: PSVT, low voltage. Synchronized recording of lead E (30 mm/mV), when tachycardia occurs P' wave amplitude > R wave amplitude, RR interval 216 ms (277 bpm), RP' 80 ms, P'R 136 ms; S1S1 interval 188 ms (320 bpm), S1S1 stimulation *5 times, termination of AVRT, restoration of sinus rhythm.

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  Figure 3. Surface ECG and esophageal ECG were recorded synchronously. The ECG parameters were as follows: EB lead (15 mm/mV), FF interval 137 ms (436 bpm), RR interval 274 ms (218 bpm), atrioventricular conduction ratio 2:1, S1S1 interval 130 ms (460 bpm). After 5 S1S1 stimuli, the rhythm transitioned to impure atrial fibrillation (AFL). Sinus rhythm was restored after 1,320 ms.

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  Figure 4. (a) AFL with a 2:1 atrioventricular conduction ratio, AFL-FF interval of 140 ms (428 bpm), RR interval of 280 ms (214 bpm), S1S1 interval of 109 ms (550 bpm). Ten consecutive S1S1 stimulations at this interval failed to terminate the AFL episode. (b) In the same patient during TEAP treatment, AFL converted to 2∼4:1 conduction. Increasing the stimulation frequency to an S1S1 interval of 100 ms (600 bpm), ten consecutive S1S1 stimulations resulted in an 880 ms long RR interval, terminating the AFL and restoring sinus rhythm.