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The optimal oesophageal pacing technique--the importance of body position, interelectrode spacing, electrode surface area, pacing waveform and intra-oesophageal local anaesthesia

Pehrson, Steen; Wedekind, Tim; Madsen-Härdig, Bjarne LU ; Holm, Magnus; Res, Jan C J and Olsson, Bertil LU (1999) In Scandinavian Cardiovascular Journal 33(2). p.103-109
Abstract
In order to improve the technique of transoesophageal atrial stimulation (TAS), the effects of body position, interelectrode spacing and electrode surface area on pacing threshold were assessed in two substudies. The effects of intra-oesophageal local anaesthesia and of two different pacing wave configurations on pacing threshold and discomfort were also assessed. Substudy I comprised 16 subjects (3 patients with a history of paroxysmal supraventricular tachycardia and 13 healthy volunteers) and substudy II comprised 16 healthy volunteers. TAS was performed using a hexapolar luminal prototype oesophageal electrode catheter. In substudy I bipolar pacing was performed in the semi-supine and left decubitus body positions for different pulse... (More)
In order to improve the technique of transoesophageal atrial stimulation (TAS), the effects of body position, interelectrode spacing and electrode surface area on pacing threshold were assessed in two substudies. The effects of intra-oesophageal local anaesthesia and of two different pacing wave configurations on pacing threshold and discomfort were also assessed. Substudy I comprised 16 subjects (3 patients with a history of paroxysmal supraventricular tachycardia and 13 healthy volunteers) and substudy II comprised 16 healthy volunteers. TAS was performed using a hexapolar luminal prototype oesophageal electrode catheter. In substudy I bipolar pacing was performed in the semi-supine and left decubitus body positions for different pulse durations (20, 10, 6 and 2 ms), interelectrode pole distances (10 to 24 mm) and electrode pole surface areas (0.22 to 0.66 cm2). In substudy II TAS was performed with square wave and triangular waveform pulses after intra-oesophageal saline and lidocaine 20 mg/ml. These solutions were given in random order. Neither the interelectrode distance nor electrode surface areas had any significant influence on pacing thresholds. Stimulation thresholds were not affected by body position. Intraoesophageal lidocaine did not affect the discomfort experienced. Peak pacing thresholds using a triangular waveform were significantly higher than thresholds using a square waveformn (p < 0.001). The optimal pacing technique for TAS remains to be defined. The TAS-induced pain is probably not generated from the oesophageal mucous membrane. There is a significant difference in pacing thresholds between triangular and square waveforms. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Cardiovascular Journal
volume
33
issue
2
pages
103 - 109
publisher
Taylor & Francis
external identifiers
  • pmid:10225312
  • scopus:0032809194
ISSN
1651-2006
DOI
10.1080/14017439950141911
language
English
LU publication?
yes
id
8a11a380-4465-4956-8aea-4b65d52bd194 (old id 1116116)
date added to LUP
2008-07-09 15:52:28
date last changed
2017-01-01 07:07:23
@article{8a11a380-4465-4956-8aea-4b65d52bd194,
  abstract     = {In order to improve the technique of transoesophageal atrial stimulation (TAS), the effects of body position, interelectrode spacing and electrode surface area on pacing threshold were assessed in two substudies. The effects of intra-oesophageal local anaesthesia and of two different pacing wave configurations on pacing threshold and discomfort were also assessed. Substudy I comprised 16 subjects (3 patients with a history of paroxysmal supraventricular tachycardia and 13 healthy volunteers) and substudy II comprised 16 healthy volunteers. TAS was performed using a hexapolar luminal prototype oesophageal electrode catheter. In substudy I bipolar pacing was performed in the semi-supine and left decubitus body positions for different pulse durations (20, 10, 6 and 2 ms), interelectrode pole distances (10 to 24 mm) and electrode pole surface areas (0.22 to 0.66 cm2). In substudy II TAS was performed with square wave and triangular waveform pulses after intra-oesophageal saline and lidocaine 20 mg/ml. These solutions were given in random order. Neither the interelectrode distance nor electrode surface areas had any significant influence on pacing thresholds. Stimulation thresholds were not affected by body position. Intraoesophageal lidocaine did not affect the discomfort experienced. Peak pacing thresholds using a triangular waveform were significantly higher than thresholds using a square waveformn (p &lt; 0.001). The optimal pacing technique for TAS remains to be defined. The TAS-induced pain is probably not generated from the oesophageal mucous membrane. There is a significant difference in pacing thresholds between triangular and square waveforms.},
  author       = {Pehrson, Steen and Wedekind, Tim and Madsen-Härdig, Bjarne and Holm, Magnus and Res, Jan C J and Olsson, Bertil},
  issn         = {1651-2006},
  language     = {eng},
  number       = {2},
  pages        = {103--109},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {The optimal oesophageal pacing technique--the importance of body position, interelectrode spacing, electrode surface area, pacing waveform and intra-oesophageal local anaesthesia},
  url          = {http://dx.doi.org/10.1080/14017439950141911},
  volume       = {33},
  year         = {1999},
}