Detection of atrial tachyarrhythmias by transesophageal pacing and recording at rest and during exercise in children with ventricular preexcitation

Ventricular preexcitation can be associated with symptomatic supraventricular tachyarrhythmias that can appear at rest and during exercise. In adults, transesophageal atrial pacing has been shown to be an effective method to induce supraventricular tachyarrhythmias and to evaluate the degree of risk in this syndrome. ^1,2 In Italy, this procedure (mandatory by law) is used at rest and during exercise in competitive athletes to induce atrial fibrillation and to predict its degeneration into ventricular fibrillation by the shortest RR interval between preexcited beats.³ In the pediatric field, children have undergone transesophageal atrial pacing at rest. In this study, we assessed the efficacy of transesophageal atrial pacing in the detection of atrial tachyarrhythmias, and for the effectiveness of therapy at rest and during exercise in children with and without evidence of arrhythmias on routine tests as a possible alternative to invasive electrophysiologic studies.