Abstract: 　Objective　To explore the clinical effect of transesophageal atrial pacing (TEAP) in the diagnosis of unexplained tachycardia in children. Methods　The results of TEAP in 28 children with unexplained tachycardia diagnosed and treated from September 2017 to August 2019 were retrospectively analyzed and were compared with the intracardiac electrophysiological study. Results　A total of 28 children (19 boys; 9 girls) with an average age of 10.8±3.7 years were treated with TEAP . There were 15 cases of atrioventricular reentrant tachycardia (AVRT), 8 cases of atrioventricular node reentrant tachycardia (AVNRT), and 2 cases of intra-atrial reentrant tachycardia (IART), and a diagnostic rate was 89.29% (25/28). The ectopic tachycardia was not induced in 3 cases. Intracardiac electrophysiological study (IEPS) was performed in 21 patients. One patient had no ectopic tachycardia induced by TEAP and was diagnosed with idiopathic right ventricular outflow tract ventricular tachycardia (RVOT-VT) by IEPS. One case of left bypass atrioventricular reentrant tachycardia (LP-AVRT) was misdiagnosed of atrial tachycardia (AT). The diagnosis results of other patients using IEPS were consistent with TEAP, and a coincidence rate was 90.48% (19/21). Conclusions　The diagnosis of tachycardia by TEAP is highly consistent with the results of IEPS. TEAP is recommended for children with clinically unexplained tachycardia, so as to clarify the diagnosis and classification of tachycardia and provide evidence for further diagnosis and treatment.

Key words: 　transesophageal atrial pacing, 　unexplained, 　tachycardia, 　child