Research Article: Analysis of the efficacy of transesophageal atrial pacing in the treatment of supraventricular tachycardia in newborns
Abstract:
To describe and explore the therapeutic value of transesophageal atrial pacing (TEAP) for supraventricular tachycardia in newborns.
Clinical data from 22 cases (15 males, 7 females) at Shanghai Children's Hospital (2015–2025) were retrospectively analyzed to evaluate the efficacy of TEAP.
Surface ECGs demonstrated paroxysmal SVT and type I atrial flutter in 11 cases respectively, with 8 patients having heart failure. After inserting the esophageal electrode catheter, transesophageal electrocardiography confirmed Atrioventricular Reentrant Tachycardia (AVRT) in 9 of 11 SVT cases; TEAP successfully terminated tachycardia in 7 (77.8% success). In a case, pulse stimulation had not yet been administered, a declining trend in blood pressure was observed, which necessitated electrical cardioversion. Another with short paroxysms post-TEAP was maintained on oral medication. Two cases of atrial tachycardia confirmed by transesophageal electrocardiogram did not respond to TEAP. Among 11 type I atrial flutter cases, TEAP restored sinus rhythm in 9 (81.8% success); one had intermittent short paroxysms and one showed reduced atrioventricular conduction, both switched to oral drugs.
TEAP is a relatively safe and effective acute treatment for reentrant SVT (AVRT, AFL) when medication cannot promptly and effectively terminate tachycardia, particularly for patients with heart failure.
Introduction:
Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in newborns ( 1 ). Persistent tachycardia can lead to heart failure, cardiogenic shock, and even death. Currently, medication is the primary method for treating tachyarrhythmias in newborns. However, pharmacological management presents unique challenges due to significant developmental differences in pharmacokinetics between newborns and older children, as well as factors such as low body weight and small organ size. TEAP is a minimally…
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