UTILITY OF THE FILTERED BIPOLAR ESOPHAGEAL LEAD IN THE DIAGNOSIS OF ARRHYTHMIAS

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概要

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• Electrophysiologic study was performed in 25 patients with tachycardia or bradycardia attacks. The coronary sinus (CS) and filtered bipolar esophageal electrograms were recorded simultaneously to compared the phase of atrial activations. During sinus rhythm and high right atrial pacing, the esophageal and proximal CS atrial activations were nearly simultaneous but earlier by 26±5 msec on the average than the distal CS atrial activations. During reciprocating tachycardia due to reentry using a left-side accessory atrioventricular pathway for retrograde conduction the esophageal and CS atrial activations occurred earlier than the low septal right atrial activation, so the esophageal lead can be used as a substitute for the CS lead to clarify the eccentric retrograde atrial activation sequence. By using the filtered bipolar esophageal lead, the interval from Q wave on the surface electrocardiogram to the first rapid deflection on the esophageal atrial activation (Q-A_<ESO> interval) was measured in 15 patients with supra-ventricular tachycardia. All patients with reciprocating tachycardia due to reentry using a left side accessory atrioventricular pathway had Q-A_<ESO> intervals between 100 to 130 msec and four of five patients with a right side accessory atrioventricular pathway for retrograde conduction had Q-A_<ESO> intervals between 130 to 150 msec. In contrast, all patients with reentry in the atrioventricular node had Q-A_<ESO> intervals between 30 to 60 msec. The esophageal lead is also of value in the prompt diagnosis of atrial flutter and ventricular tachycardia, since the esophageal electrograms readily reveal the relationship between atrial and ventricular activations. In conclusion, the filtered bipolar esophageal lead provides a non-invasive method for the quick diagnosis of various arrhythmias.

• 社団法人日本循環器学会の論文
• 1984-12-20

著者

• Komatsu Chikayoshi

  The Fourth Division Department Of Internal Medicine Jikei University School Of Medicine

• Ishinaga Takanari

  The Fourth Division Department Of Internal Medicine Jikei University School Of Medicine

関連論文

• DIFFERENTIATION OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA BY THE FILTERED BIPOLAR ESOPHAGEAL ELECTROGRAMS : Arrhythmia : FREE COMMUNICATIONS (Abstract) : 45 Annual Scientific Meeting, Japanese Circulation Society
• THE COMPARATIVE EFFECTS OF 6 ANTIARRHYTHMIC DRUGS ON INDUCTION AND TERMINATION OF RE-ENTRANT PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA STUDIED BY PROGRAMMED ELECTRICAL STIMULATION OF THE HEART : Antiarrhythmic Drugs : IV Auditorium : PROCEEDINGS OF THE 44th
• UTILITY OF THE FILTERED BIPOLAR ESOPHAGEAL LEAD IN THE DIAGNOSIS OF ARRHYTHMIAS

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