All issues > Volume 37(7); 1994

Original Article

J Korean Pediatr Soc. 1994;37(7):969-975. Published online July 15, 1994.

Atrial Flutter Conversion in Infants and Children Using Transesophageal Atrial Pacing

Jae Kon JK Ko¹, Seoug Ho SH Kim¹, Eun Jung EJ Bae¹, I Seok IS Kang¹, Heung Jae HJ Lee¹

¹Department of Pediatrics, Sejong General Hospital, Bucheon, Korea

Abstract

Atrial flutter is an infrequent, but potentially unstable tachyarrythmia that occurs in pediatric ages. Transesophageal atrial pacing was used for treatment of 10 episodes of atrial flutter in 7 patients. At the time of atrial flutter conversion, patients were 6 days to 14 years old. 6 patients had associated with congenital heart disease. The atrial cycle length of atrial flutter ranged from 140 to 280 msec with variable atrioventricular conduction. Transesophageal atrial pacing was performed using a bipolar 4 F transesophageal electrode catheter. Atrial flutter conversion was accomplished with stimulation bursts using about 5 seconds of stimuli, 10 msec in duration at 20 to 27 mA. Pacing cycle length was 45 to 110 msec less than the atrial cycle length of tachycardia in 6 episodes. But in a neonate, underdrive pacing converted atrial flutter to sinus rhythm. Conversion attempts were unsuccessful on 2 occasions. Transesophageal atrial pacing is a safe and effective, minimally invasive technique for treatment of atrial flutter in infants and children.

Keywords :Atrial flutter, Transesophageal atrial pacing