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Role of Transesophageal Pacing in Evaluation of Palpitation in Infants and Children

Journal of the Korean Pediatric Society 2003;46(1):51-55.
Published online January 15, 2003.
Role of Transesophageal Pacing in Evaluation of Palpitation in Infants and Children
Su-Jeong Ryu, Jae Kon Ko, Young Hwue Kim, In Sook Park
Division of Pediatric Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
심계항진을 호소하는 소아에서 경식도 심전도 검사의 유용성
류수정, 고재곤, 김영휘, 박인숙
울산대학교 의과대학 서울아산병원 소아심장과
: We intended to find out the role of transesophageal atrial pacing in evaluation of infants and children with palpitation of unknown origin.
: We tried transesophageal atrial pacing study in 69 infants and children with palpitation, in whom tachycardia wasn't documented in electrocardiogram and reviewed retrospectively the records of transesophageal pacing and medical records of theses patients to find out the induction rate of tachycardia by transesophageal atrial pacing and the possible mechanism of tachycardia if induced.
: In 70.1% infants and children with palpitation, tachycardia was induced, so we could conclude that tachycaridia was the cause of palpitation in these cases. In most cases, tachycardia was induced by rapid atrial pacing, and in 21% by using isoproterenol. Tachycardia induction rate was higher in <6-year-old children than ≥6-year-old children(P<0.05). In cases of the induced, we reviewed the mechanism of tachycardia. Of these induced tachycardias, 53.2% is atrioventricular reentry tachycardia, 34.0% were atrioventricular nodal reentry tachycardia, and 12.8% were idiopathic left ventricular tachycardia. Invasive electrophysiologic study was done to 10 patients of those induced. The results of electrophysiologic study and transesophageal pacing and recording were the same except for one patient.
: Transesophageal atrial pacing and recording is a less invasive, safe and useful method to find out the cause of palpitation and the mechanism of tachycardia in infants and children.
Key Words: Palpitation, Tachycardia, Transesophageal atrial pacing and recording

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