The patient is a 19 years-old man who often wakes up in dreams with palpitations and fatigue. The ECG shows: 1. Sinus rhythm; 2. Preexcitation syndrome. Transesophageal electrophysiological study (TEEPS) diagnosis:High-risk accessory pathway. During radiofrequency catheter ablation, the patient suddenly developed atrial fibrillation and quickly converted to ventricular fibrillation. After defibrillation, ventricular fibrillation is transformed into sinus rhythm. Subsequently, the patient's high-risk accessory pathway was successfully ablated. Studies have shown that about 25% of patients with WPW syndrome have a refractory period of less than 250 ms, which is one of the risk factors for the conversion of atrial fibrillation to ventricular fibrillation. Therefore, risk stratification is recommended for these symptomatic patients. From 1980 to 1990, there were literature reports on risk stratification of patients with preexcitation syndrome by TEEPS. But it has not become a routine examination of risk stratification in patients with preexcitation syndrome.The reason may be related to the hardware conditions and risk stratification methods used at that time. The TEEPS equipment currently used in our hospital can control the pacing voltage at about 12 mv on average. The voltage in this case report is 9 mv only. In addition, we successfully stratified the risk of patient with preexcitation syndrome without inducing atrial fibrillation. All the electrophysiological records of the patient during the examination were recorded simultaneously with the 12-lead ECG and the esophageal lead ECG. These improvements makes TEEPS a simple, safe and reliable non-invasive cardiac electrophysiological detection technology, which is worth popularizing in hospitals.

中文翻译：

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通过改进的经食道电生理研究成功对心室预激患者进行风险分层

患者是一名19岁的男子，经常在梦中醒来，心悸乏力。心电图显示： 1. 窦性心律；2.预激综合征。经食管电生理研究 (TEEPS) 诊断：高危旁路。在射频导管消融过程中，患者突然发生房颤并迅速转为心室颤动。除颤后，心室颤动转变为窦性心律。随后，患者的高危旁路被成功消融。研究表明，约25%的WPW综合征患者的不应期小于250 ms，这是房颤转为心室颤动的危险因素之一。因此，建议对这些有症状的患者进行风险分层。1980～1990年间有文献报道TEEPS对预激综合征患者进行危险分层。但并未成为预激综合征患者风险分层的常规检查，其原因可能与当时使用的硬件条件和风险分层方法有关。我院目前使用的TEEPS设备可将起搏电压控制在平均12mv左右。本案例报告中的电压仅为 9 mv。此外，我们成功地对预激综合征患者的风险进行了分层，而不会诱发心房颤动。患者在检查过程中的所有电生理记录均与12导联心电图和食管导联心电图同时记录。这些改进使 TEEPS 变得简单，