Falk R H, Werner M
Chest. 1987 Jul;92(1):110-4. doi: 10.1378/chest.92.1.110.
To determine the efficacy of transesophageal rapid atrial pacing with a "pill-electrode" for the termination of atrial flutter, we studied 14 consecutive unselected patients presenting with atrial flutter of various etiologies. The bipolar pill-electrode (interelectrode distance 13 mm) was introduced orally without sedation. Of 14 pacing attempts, atrial capture was obtained in 13 (93 percent), and sustained alteration in rhythm (atrial fibrillation, sinus rhythm or type 2 flutter) in 12 (86 percent). Normal sinus rhythm occurred in six (43 percent), in all of whom it was preceded by transient atrial fibrillation. There was no difference in baseline flutter rates, pacing rates for atrial capture, or duration of flutter between patients reverting to sinus rhythm and those remaining in flutter or converting to atrial fibrillation. Pacing was well tolerated in all but one subject. Thus, esophageal pacing with the pill-electrode was simple to perform, well-tolerated and highly successful for atrial capture in patients with atrial flutter. Although it had a lower success rate than DC cardioversion in producing sinus rhythm, the simplicity of application makes it a useful initial alternative, particularly in patients in whom cardioversion may be hazardous.
为确定使用“药丸电极”经食管快速心房起搏终止心房扑动的疗效，我们对14例连续入选的病因各异的心房扑动患者进行了研究。双极药丸电极（电极间距13毫米）在未使用镇静剂的情况下经口插入。在14次起搏尝试中，13次（93%）实现了心房夺获，12次（86%）出现了节律的持续改变（心房颤动、窦性心律或2型扑动）。6例（43%）恢复为正常窦性心律，所有这6例在恢复窦性心律之前均出现过短暂心房颤动。恢复窦性心律的患者与仍为心房扑动或转为心房颤动的患者在基线扑动率、心房夺获的起搏率或扑动持续时间方面无差异。除1例受试者外，所有患者对起搏耐受性良好。因此，对于心房扑动患者，使用药丸电极进行食管起搏操作简单、耐受性良好且心房夺获成功率高。尽管其在产生窦性心律方面的成功率低于直流电复律，但操作的简便性使其成为一种有用的初始替代方法，特别是对于那些电复律可能有风险的患者。
