Study of Wolff-Parkinson-White syndrome by transesophageal pacing and assessment of long-term amiodarone therapy

Transesophageal atrial pacing has been used for the induction of supraventricular tachycardia (SVT) for diagnostic and therapeutic purposes.¹ Recently, Critelli et al² evaluated in 5 patients with the Wolff-Parkinson-White (WPW) syndrome, the effect of amiodarone administered during 1 month on induced atrial fibrillation and on the shortest cycle length with a 1:1 atrioventricular (AV) conduction over the accessory pathway. When an antiarrhythmic drug is administered, it is necessary to study the maximal response when steady-state tissue concentrations are reached. For this reason, amiodarone, which has an estimated half-life of about 40 days, should be evaluated after at least 2 or 3 half-lives. This report analyzes the use of transesophageal atrial pacing in the study of patients with WPW syndrome and the repeated assessment of the efficacy of long-term amiodarone administration.