and contract PH-43-67-1440.

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 perma-nent radiofrequency-controlled atrial pacemaker. Several days after implantation of the pacemaker, however, rapid atrial pacing produced atrial tachycardia with atrio-ventricular block rather than atrial fibrillation. Despite this apparent failure, the ven-tricular 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. Additional Indexing Words: Supraventricular tachycardia Arti pAROXYSMAL supraventricular tachycar-dia in the absence of significant cardiac disease is usually managed with relative ease. Attacks can be prevented either by eliminat-ing agents which obviously incite the ar-rhythmia or by using conventional antiar-rhythmic therapy. Our patient was unusual in that paroxysmal tachycardia resulted in virtual incapacitation and could not be prevented even with large and toxic amounts of drugs. The problem was finally managed successfull