Nowa elektroda przełykowa do szybkiego wdrażania stymulacji przedsionków w czasie znieczulenia ogólnego

*Fryderyk Prochaczek¹, Mirosław Sikora², Jerzy Gałecka³, Roman Zając⁴

Summary
Background.Commonly used oesophageal pacing electrodes are difficult to introduce via the nasal route and require time and expertise to avoid intratracheal placement and/or impaction in the piriform fossa.
Methods. We constructed a new electrode of unique shape, facilitating efficient introduction through either the mouth or the nose. The bipolar, 28 F electrode (Hagmed, Poland) was used in 44 patients having surgery under general anaesthesia. The electrode was designed to be easy to introduce via the nasal route and to make it possible to position the poles as close to the heart as possible.
For assessment, we measured the time necessary for placement of the electrode and the time to start effective pacing. The atrial excitation thresholds were determined for rectangular pulses which were 10, 20 and 30 ms wide.
Results. The time to effective placement of the electrode was 5 sec (oral route) and 91 sec (nasal route). The atrial pacing threshold was found to be very low (4.4 mA for a 30 ms pulse), compared to 16-28 mA, described for 18 F, ring-shaped electrodes.
Discussion and conclusion. The results confirmed the usefulness of the new electrode. It was easy to introduce, and thanks to its unique shape and wide diameter, it was possible, in the majority of patients, to begin atrial pacing with low current less that two minutes after commencing insertion The electrode makes possible, the emergency use of atrial pacing during anaesthesia and resuscitation.

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