Conversion of Supraventricular Tachyeardias with Rapid Atrial Stimulation

Rapid atrial stimulation (RAS) is a technic useful for converting the rapid ventricular response of atrial tachycardia, atrial flutter, or junctional tachycardia to a slower ventricular rate with normal sinus rhythm or atrial fibrillation. It is particularly useful when alternate methods such as DC cardioversion, carotid sinus massage, and drug therapy are either ineffective or undesirable. It is safe in patients with digitalis intoxication, does not require general anesthesia, documents atrial rhythm, and can be used repetitively without cumulative effects. RAS was performed 129 times in 87 patients (45 males; 42 females) whose ages ranged from 33 to 90 years (mean 67 years). There were no major complications. Overall, including both initial and repeat attempts, RAS successfully converted supraventricular tachycardia in 71% of cases and failed in 29%.