Two Cases of SVT Induced by Combined Exercise Test during Esophageal Cardiac Electrophysiological Examination

Abstract

Background: Transesophageal cardiac electrophysiology is a safe, effective, and noninvasive cardiac electrophysiologic test. Combined with the supine position power treadmill exercise test, modulation of autonomic function and adjustment of the myocardial tissue conduction system due period can significantly improve the success rate of TECEE evocation and has important applications in risk stratification of ventricular preexcitation syndrome..

Case presentation: Case 1: A 34-year-old male presented with recurrent palpitations that had persisted for 10 years. No supraventricular tachycardia (SVT) was recorded on the electrocardiogram (ECG), and the type of SVT could not be definitively diagnosed. Transesophageal electrophysiological study (TEEPS) with atrial stimulation failed to induce SVT. However, after performing the supine bicycle exercise test in combination, slow-fast atrioventricular nodal reentrant tachycardia (AVNRT) was successfully induced. Case 2: A 59-year-old female presented with recurrent palpitations for three years. The duration of the SVT episodes was short, and the diagnosis was unclear. TEEPS with atrial stimulation showed occasional premature atrial contractions; however, SVT was not induced. However, after performing the supine bicycle exercise test in combination, sinoatrial nodal reentrant tachycardia (SANRT) was successfully induced.

Conclusion: Transesophageal cardiac electrophysiology is a noninvasive cardiac electrophysiological examination technique used for diagnosing paroxysmal supraventricular tachycardia and terminating tachycardia. In particular, when combined with supine bicycle exercise testing, it can increase the success rate of inducing supraventricular tachycardia, further evaluate the mechanism of tachycardia, and provide an important reference value for clinical risk stratification of radiofrequency catheter ablation and surgery.