title: [Diagnostic transoesophageal atrial stimulation].
abstract: BACKGROUND
  We wanted to evaluate transoesophageal atrial stimulation as a diagnostic tool in the evaluation of paroxysmal supraventricular tachycardias.
  
  
  METHODS
  185 procedures in 177 patients were evaluated retrospectively. The main reasons for referral to transoesophageal atrial stimulation were documented (52%) or suspected (43%) paroxysmal supraventricular tachycardias. The procedure consisted of incremental atrial stimulation to second degree A-V block, adding up to three extra stimuli, repeating the protocol with isoprenalin 2 and 5 mg/min and completing the procedure with rapid atrial stimulation 300-800/min. Induced tachycardias were classified according to the R-P interval.
  
  
  RESULTS
  The procedure was well tolerated. Supraventricular tachycardias were induced in 72/96 (75%) of patients with documented paroxysmal supraventricular tachycardias and in 41/80 (51%) of patients with suspected paroxysmal supraventricular tachycardias. Out of the 101 patients (55%) who were referred for invasive electrophysiological study, 79 (78%) had an inducible supraventricular tachycardia at transoesophageal stimulation. When stimulation resulted in a tachycardia with measurable R-P interval, the accuracy of our diagnosis was 87%.
  
  
  CONCLUSIONS
  Transesophageal atrial stimulation has proved to be a useful diagnostic tool in the management of paroxysmal supraventricular tachycardias at our hospital. Nearly half the patients required no further investigations after transoesophageal atrial stimulation.
authors.affiliation: Kardiologisk seksjon, Medisinsk avdeling, Alesund sjukehus. r-haal@online.no
authors.forename: Hilde Hellebust
authors.initials: HH
authors.lastname: Haaland
authors.forename: Torstein Holm
authors.initials: TH
authors.lastname: Morstøl
authors.forename: Johnny
authors.initials: J
authors.lastname: Vegsundvåg
authors.forename: Torstein
authors.initials: T
authors.lastname: Hole
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D002648:Child; D004947:Esophagus; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology