Analysis of the efficacy of transesophageal atrial pacing in the treatment of supraventricular tachycardia in newborns.

OBJECTIVE: To describe and explore the therapeutic value of transesophageal atrial pacing (TEAP) for supraventricular tachycardia in newborns. METHODS: Clinical data from 22 cases (15 males, 7 females) at Shanghai Children's Hospital (2015-2025) were retrospectively analyzed to evaluate the efficacy of TEAP. RESULTS: Surface ECGs demonstrated paroxysmal SVT and type I atrial flutter in 11 cases respectively, with 8 patients having heart failure. After inserting the esophageal electrode catheter, transesophageal electrocardiography confirmed Atrioventricular Reentrant Tachycardia (AVRT) in 9 of 11 SVT cases; TEAP successfully terminated tachycardia in 7 (77.8% success). In a case, pulse stimulation had not yet been administered, a declining trend in blood pressure was observed, which necessitated electrical cardioversion. Another with short paroxysms post-TEAP was maintained on oral medication. Two cases of atrial tachycardia confirmed by transesophageal electrocardiogram did not respond to TEAP. Among 11 type I atrial flutter cases, TEAP restored sinus rhythm in 9 (81.8% success); one had intermittent short paroxysms and one showed reduced atrioventricular conduction, both switched to oral drugs. CONCLUSION: TEAP is a relatively safe and effective acute treatment for reentrant SVT (AVRT, AFL) when medication cannot promptly and effectively terminate tachycardia, particularly for patients with heart failure.