title: Termination of atrial flutter by directed transesophageal atrial pacing during transesophageal echocardiography.
abstract: BACKGROUND
  The purpose of this study was to evaluate termination of atrial flutter (AFL) by directed rapid transesophageal atrial pacing (TAP) with and without simultaneous transesophageal echocardiography (TEE) performed using a novel TEE tube electrode.
  
  
  RESULTS
  A total of 16 AFL patients (age 63+/-12 years; 13 males) with mean AFL cycle length of 224+/-24 ms (n=12) and mean ventricular cycle length of 448+/-47 ms (n=12) were analyzed using either an esophageal TO electrode (n=10) or a novel TEE tube electrode consisting of a tube with four hemispherical electrodes that is pulled over the echo probe (n=6). AFL could be terminated by directed rapid TAP using an esophageal TO electrode, leading to induction of atrial fibrillation (AF) (n=6), induction of AF and spontaneous conversion to sinus rhythm (SR) (n=3), and with conversion to SR (n=1). AFL could also be terminated by directed rapid TAP using the TEE tube electrode, with induction of AF (n=3) or induction of AF and spontaneous conversion to SR (n=3).
  
  
  CONCLUSIONS
  AFL can be terminated by directed rapid TAP with hemispherical electrodes with and without simultaneous TEE. TAP with the directed TEE tube electrode is a safe, simple, and useful method for terminating AFL.
authors.affiliation: Department of Internal Medicine I, Cardiology Division, Friedrich Schiller University of Jena, Jena, Germany. matthias.heinke@med.uni-jena.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Heinke
authors.forename: Helmut
authors.initials: H
authors.lastname: Kühnert
authors.forename: Ralf
authors.initials: R
authors.lastname: Surber
authors.forename: Peter
authors.initials: P
authors.lastname: Osypka
authors.forename: Hans
authors.initials: H
authors.lastname: Gerstmann
authors.forename: Jens
authors.initials: J
authors.lastname: Haueisen
authors.forename: Tobias
authors.initials: T
authors.lastname: Heinke
authors.forename: Dirk
authors.initials: D
authors.lastname: Reinhard
authors.forename: Dirk
authors.initials: D
authors.lastname: Prochnau
authors.forename: Gudrun
authors.initials: G
authors.lastname: Dannberg
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001282:Atrial Flutter / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome