Mainardi M A, Cioppi F, Marconi M, Sermasi S
Unità Operativa di Elettrofisiologia ed Elettrostimolazione Cardiaca, Ospedale Infermi, USL 40, Rimini, FO.
Cardiologia. 1992 Apr;37(4):297-9.
Transesophageal atrial overdrive stimulation is a widely used technique for the interruption of atrial flutter and supraventricular tachyarrhythmias. We describe a case of 60 year old man with a previous myocardial infarction, suffering from angina during effort after aortocoronary bypass who presented several episodes of atrial flutter treated with success by transesophageal atrial overdrive stimulation using swallowing electrodes. During the treatment of the last episode of atrial flutter, after a 5 s burst at 300 b/min ventricular fibrillation occurred and was promptly interrupted by DC shock. This is the first case in our experience and probably the first report of ventricular fibrillation induced by swallowing electrodes. Possible mechanisms as pharmacological interactions, accidental ventricular stimulation, etc, are discussed. In conclusion, even though the risk of dangerous arrhythmias is very low, transesophageal atrial overdrive stimulation should be performed by experts in an equipped room.
经食管心房超速刺激是一种广泛应用于中断心房扑动和室上性快速心律失常的技术。我们描述了一例60岁男性患者，既往有心肌梗死病史，在主动脉冠状动脉搭桥术后用力时出现心绞痛，该患者发生了几次心房扑动发作，通过使用吞咽电极的经食管心房超速刺激成功治疗。在治疗最后一次心房扑动发作期间，以300次/分钟的频率进行5秒猝发刺激后发生了心室颤动，并立即通过直流电电击中断。这是我们经验中的首例病例，可能也是关于吞咽电极诱发心室颤动的首例报道。文中讨论了诸如药物相互作用、意外心室刺激等可能的机制。总之，尽管危险心律失常的风险非常低，但经食管心房超速刺激应由专家在配备完善的房间内进行。
