文本框: TERMINATING ATRIAL FLUTTER WITH TRANSESOPHAGEAL ATRIAL PACING IN CHILDREN Wang Jianyi, Li Jinkang, Huang Min, Chen Xiuyu Shanghai Children’s Hospital, Shanghai, China Objective: To study the transesophageal atrial pacing (TEAP) for terminating atrial flutter (AF) in children. Methods: Transesophageal atrial overdrive pacing was applied for terminating persistent AF in 5 children with organic heart diseases (postoperative Tetralogy of Fallot 1, atrial septal defect 3, myocarditis 1). Result: Four patients with AF after successfully converted to sinus rhythm were given digoxin and propranolol for prevention of recurrence. One patient showing non-sustained junctional escape rhythm after TEAP was thus comfirmed as case of tachycardia-bradycardia syndrome. At follow up, 4 patients remained sinus rhythm and 1 patient showed alternation of junctional escape rhythm and AF. Conclusion: High sudden death rate in children with persistent AF is quite common. It’s very improtant to terminate AF immediately. There are three proposed eletrophysiologic mechanisms for AF: (1) automaticity (2) reentry and (3) triggered activity. It is now generally accepted that AF is caused by reentry so may be terminate with overdrive pacing. Converting AF to sinus rhythm with TEAP is relatively safe, simple and noninvasive than drug therapy, direct-current cardioversion, overdrived pacing in artium and radiofrequecy catheter ablation. [Key words] Artial flutter, Transesophageal atrial pacing, Children 0752