Mabo P, Gras D, Leclercq C, Daubert C
Service de cardiologie A, CHRU, 2, Rennes.
Arch Mal Coeur Vaiss. 1995 Dec;88 Spec No 5:43-7.
The possibility of detecting the electrical activity of the heart from the oesophageus has been recognised for nearly a century. On the other hand, transesophageal pacing has only been really developped in the last fifteen years, which explains the recent interest for this technique in clinical practice. Easily put into practice, but not always well tolerated, the oesophageal approach has many uses in rhythmology. The principal diagnostic applications are in unlabelled tachycardias whether with narrow or wide QRS complexes, the evaluation of the Wolff-Parkinson-White syndrome, the study of sinus node function or nodal conduction. The therapeutic applications are dominated by the reduction of supraventricular tachycardias especially atrial flutter, with a success rate similar to that of endocavitary stimulation. The facility of realisation, especially at the patient's bedside, without need for fluoroscopie control, makes it a useful tool in emergencies, especially if the endocavitary approach cannot be used. The only reserve is the painful character of pacing in some patients.
从食管检测心脏电活动的可能性已被认识近一个世纪了。另一方面，经食管起搏在过去十五年才真正得到发展，这就解释了近期临床实践中对该技术的兴趣。食管途径易于实施，但患者耐受性不一，在心律失常学中有多种用途。主要诊断应用在于不明原因的心动过速，无论QRS波群是窄还是宽，用于评估预激综合征、研究窦房结功能或结传导。治疗应用主要是用于终止室上性心动过速，尤其是心房扑动，成功率与心腔内刺激相似。该方法易于实施，尤其是在患者床边，无需荧光透视控制，使其成为紧急情况下的有用工具，特别是在心腔内途径无法使用时。唯一的不足是在一些患者中起搏会引起疼痛。
