Lipnitskii TN, Radnin AG, Stepaniuk AV, Kotsuta GI. Klin Med (Mosk) 1993;71(5):41-4. The authors propose a new stepwise method of intensive therapy of atrial flutter (AF) based on atrial transesophageal pacing (ATEP) the efficacy of which was raised by previous digitalization. Patients of group 1 (n = 25) were scheduled to have ATEP, in its inefficacy ATEP was to be followed by antiarrhythmic drugs and on-demand cardioversion. In patients of group 2 (n = 27) ATEP was preceded by digitalization. ATEP and antiarrhythmic chemotherapy resulted in restoration of the sinus rhythm in 48% of the cases, cardioversion was performed in 11 patients of group 1. In group 2 normal rhythm was reestablished in 88% of the patients, 2 patients experienced cardioversion. The proposed variant of treatment is advocated as an alternative to cardioversion.