Value of oesophageal pacing in evaluation of atrial arrhythmias.

The study of 'atrial vulnerability' is often clinically indicated but it requires the use of invasive intracardiac stimulation. The purpose of the study was to assess the use of oesophageal pacing in the evaluation of atrial tachyarrhythmias (ATA). Fifty-five patients with documented ATA (group I) and 60 without (group II) were studied. The protocol of oesophageal pacing consisted of atrial pacing up to the second-degree AV block and programmed stimulation in the control state and after isoproterenol infusion. ATA was induced in 47 group I patients (85%) either in the control state (n = 27) or during isoproterenol infusion (n = 20) and in three group II patients (5%). There was no other electrophysiological abnormality. The presence of underlying heart disease did not precipitate ATA in group II. In conclusion, because of its good sensitivity (85%) and specificity (95%) transoesophageal pacing could be used to evaluate atrial arrhythmias.