0018: Clinical interest of transesophageal electrophysiological study in patients with no documented tachycardia suspected of paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia (SVT) documentation is not always easy and in some patients referred for SVT ablation, EPS sometimes remains negative. The purpose of study was to evaluate the follow-up after esophageal EPS for no documented tachycardia. Methods 1569 patients, mean age 42±19.5 years, 637 males, with normal ECG in sinus rhythm, were suspected of SVT. Exercise testing, 24 hour Holter monitoring were normal. Transesophageal EPS consisted of programmed stimulation with 1 and 2 extrastimuli in control state and after isoproterenol. Results EPS remained negative in 594 patients (group I). Atrial fibrillation/tachycardia (AF) was induced in 70 patients (group II), atrioventricular (AV) nodal reentrant tachycardia (AVNRT) or AVRT using a concealed accessory pathway in 887 patients (group III). Group I was younger (34±17 years) than group II (53±16), III (46±20)(p Conclusions Prognosis value esophageal EPS was excellent. A negative study noted in younger patients complaining frequently of dizziness/syncope/ chest pain predicted a favorable prognosis. None of the patients with induced AF had AVNRT/AVRT and this group (older, with HD) had frequently AF during follow-up (20%). Patients with induced AVNRT/AVRT benefit frequently from ablation of their tachycardia.