THE APPLICATION OF BIPOLAR CHEST LEAD IN TRANSESOPHAGEAL ATRIAL PACING
Introduction: Bipolar chest (BC) lead is an electrocardiographic conductor with two electrodes placed on different sites of the right chest wall, we performed this test to explore the value of BC lead in localization diagnosis of orthodromic atrioventricular reciprocating tachycardia (OAVRT) in transesophageal atrial pacing (TEAP).
Method: Choose 51 OAVRT cases induced by TEAP, their routine 12 lead ECG,esophageal bipolar lead ECG and bipolar chest lead ECG were simultaneously recorded, then analyze the form and sequence of P waves in different leads.
Results: PBC were round,blunt and upward,While they were taller , clearer and slightly faster than P EB in all 51 cases before OAVRT was induced. When the OAVRT was induced, P-V1 could be seen clearly in 17 cases, P-BC could be seen clearly in 21 cases, both P-V1 and P-BC could be seen clearly at same time in 13 cases. The incidence rate of P-BC was statistically higher than P-V1(ang1055 p 0.05). P-BC appeared earlier than P-EB when the accessory atrioventricular pathways were right-sided, while P-EB appeared earlier than P-BC when the accessory atrioventricular pathways were left-sided (Fig. 44.1.).
Conclusions: BC lead can help improve the accuracy rate of localization in diagnosis of OAVRT by recording clear P wave combining with the V1 lead in TEAP