The Clinical Research On Transesophageal Electric Cardioversion Of Atrial Flutter

Objective To observe and compare the effects of transesophageal electric cardioversion and transesophageal atrial pacing (TEAP) on cardioversion of atrial flutter(AFL), and to guide patients of AFL to choose a better cardioversion method to treat AFL.Method60patients with AFL were chosen from in-patient and out-patient department of cardiology and emergency center. They had applied antiarrhythmic drugs over three days failed to sinus rhythm, including37males and23females mean age (47.5±13.6) years old.39patients of them received structural heart disease, including17cases with coronary heart disease,9cases with rheumatic heart disease,6cases with hypertensive heart disease,3cases with congenital heart disease, and4cases with hyperthyroid heart disease. There were21cases of patients did not find definite reason.60patients with AFL were randomly divided into two groups (A and B group). Each group had30patients. Group A used a novel esophageal electric balloon electrode system was designed by Zheng Fangsheng on transesophageal electric cardioversion of AFL. Group B applied an ordinary metal ring electrode catheter on TEAP of AFL. Then recorded and compared success rates, intubation depths and adverse reactions of two groups.Result Group A with a novel esophageal electric balloon electrode system firstly used20J to discharge and if not succeed,30J again. A total of28patients with AFL changed into sinus rhythm. The total success rate was93.3%. The incidence of adverse reactions was16.7%.The intubation depth was (36.60±1.28) cm. There were22patients with AFL succeeded to sinus rhythm in Group B with an ordinary metal ring electrode catheter on TEAP. The success rate was73.3%. The incidence of adverse reactions was80.0%. The intubation depth was (36.97±1.33) cm. Heart palpitations, chest tightness and other symptoms of patients in two groups disappeared or reduced after cardioversion. Group A had higher success rate (P<0.05) and lower incidence of adverse reactions (P<0.05) than group B. The depths inserted into the esophagus were no difference between two groups (P>0.05).Conclusion Transesophageal electric cardioversion of AFL with the esophageal electric balloon electrode system has many advantages than TEAP with ordinary metal ring electrode catheter, such as higher success rate and lower incidence of adverse reactions. Transesophageal electric cardioversion needs low energy and is safer for patients. It is easy to operate and master, and it is a worthy cardioversion method that can be applied extensively in clinical work.