To the Editor:-Recently, Broka et al. [1]described the use of transesophageal atrial pacing as a trigger for an intraaortic balloon pump (IABP). I have had difficulty in doing so with the IABPs I have available. In some situations, the IABP console did not recognize the atrial stimulus, and sometimes recognized it as the ventricular complex (Datascope Systems 90 and 95 respectively, Datascope, Paramus, NJ). In the latter situation, appropriate timing could be achieved by significantly delaying inflation and deflation when timing off of the transesophageal atrial pacing stimulus. In our cases, fortunately, we were able to time the IABP off the pressure waveform. It would be of interest to know which IABP they used.

Jonathan V. Roth, M.D., Chairman Emeritus, Department of Anesthesiology, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, Pennsylvania 19141.

(Accepted for publication October 18, 1996.)

Broka SM, Ducart AR, Collard EL, Thiry DJ, Louagie UAG, Delire YR, Mayne AJ, Randour PR, Joucken KL: Transesophageal atrial pacing as a trigger for intraaortic balloon pumping. Anesthesiology 1996; 84:473.