Intraatrial reentry tachycardia is a common cause of both morbidity and mortality after surgery for a variety of congenital heart defects. Despite an armamentarium of arrhythmia management tools, including drug therapy, antibradycardia, and antitachycardia pacing, and catheter ablation, management of these arrhythmias remains a challenge. This report briefly reviews the problem, assesses the current successes and failures of radiofrequency catheter ablation for treating it, and discusses a number of ongoing developments that may improve both early and late outcome.