Cardioversion of intraatrial reentrant tachycardia using rate response

Intraatrial reentrant tachycardia (IART) is the most common long-term, surgical arrhythmia sequela in patients with complex congenital heart disease. The management of IART is challenging. Medications, catheter ablation therapy, and pacemaker therapy have all been utilized as treatment options. Slower tachycardia cycle lengths and 1:1 atrioventricular conduction provide even more challenges with regard to detection and antitachycardia pacing. We describe the use of the rate response feature as a means of patient-initiated cardioversion.