Electrically Induced Atrial Tachycardia with Block

Atrial tachycardia with block was induced by rapid atrial pacing in a patient with refractory supraventricular tachycardia in an effort to control the ventricular rate. It was initially decided to induce atrial fibrillation as necessary with the use of a permanent radiofrequency-controlled atrial pacemaker. Several days after implantation of the pacemaker, however, rapid atrial pacing produced atrial tachycardia with atrioventricular block rather than atrial fibrillation. Despite this apparent failure, the ventricular rate has been adequately controlled by rapid atrial pacing for the past 9 months. Intermittent induction of atrial tachycardia with block with a permanent radiofrequency atrial pacemaker may represent a useful approach to the treatment of patients with refractory supraventricular tachycardia.