Yu.V. Zinchenko Influence of functional state of atrioventricular conduction upon transesophageal electric cardiac stimulation efficacy in patients with atrial flutter type I

We performed 573 transesophageal electric cardiac stimulation (TEECS) procedures in order to restore sinus rhythm in isolated atrial flutter (AF) type I in patients with coronary arteries disease (CAD) (n=420) and myocardial fibrosis (n=153). Concomitant arterial hypertension was present in 385 patients. Mean arrhythmia anamnesis constituted 5 years with mean current arrhythmia episode duration of (38.0±2.7) days. Depending on
function of atrioventricular (AV) conduction all patients were divided into three groups: group 1 (n=345) – tachysystolic form of AF, group 2 (n=200) – normosystolic AF, and group 3 (n=28) – bradysystolic AF. According
to the results of our study no influence of AV conduction upon TEECS efficacy was revealed in patients with long lasting (over 35 days) isolated AF type I. Tachysystolic AF does not exclude sinus node dysfunction in the studied patients. Therefore, it is reasonable to stop administration of AV conduction inhibiting agents in order to prevent hemodynamically significant bradycardia or blocks. Bradysystolic AF was significantly more often observed in patients with CAD, functional and organic AV conduction violations. That is why administration of antiarrhythmic agents before TEECS is not reasonable due to significant increase of side effects occurrence.

Full article