How does transesophageal atrial pacing compare with alternative therapies?
TAP vs. external transcutaneous/transchest pacing. Esophageal pacing is administered via the left atrium while transthoracic pacing is generally accomplished via stimulation of the ventricles. Atrial pacing is contra-indicated in patients with complete AV heart block. In patients with a functioning AV node, atrial pacing provides greater hemodynamic benefits compared to ventricular pacing (Topol et al). TAP is achieved with lower current (10-20 mA vs. 30-140 mA) and better patient tolerance compared to pacing from the chestwall (Alezedo et al, Madsen et al, Atlee et al, McEneaney et al). A comparison of transesophageal rapid atrial pacing vs. transchest DC shock for terminating atrial flutter found similar efficacy between the two methods (Tucker et al); arrhythmias (3rd degree heart block, non-sustained ventricular tachycardia) were observed more frequently in cases receiving transchest shock (60% vs. 0%). TAP vs. transvenous/endocardial pacing and recording. TAP is administered via t
