II. Definitions
- Atrial Tachycardia
- Form of Paroxysmal Supraventricular Tachycardia (10% of cases) with increased automaticity
III. Epidemiology
- Least common Supraventricular Tachycardia (10% of cases, less common than AVNRT, AVRT)
- Most often in otherwise healthy young adults
IV. Pathophysiology
V. Findings: Electrocardiogram
-
Heart Rate 130 to 180 (up to 250 bpm)
- Contrast with Atrial Flutter (250 to 350 bpm)
- At least one atrial beat for every ventricular beat
- However atrial beats may exceed ventricular beats (e.g. 1:1 or 1:4 AV conduction)
- Similar to Atrial Flutter, but Atrial Tachycardia rates are slower (<250 bpm)
- May occur in repetitive short bursts of Atrial Tachycardia
- P Wave morphology varies by atrial focus and is best visualized in leads V1 and II
- PR Interval is normal
- RP Interval is longer than PR Interval
- When due to increased automaticity
- Rate typically ramps up over a 5 to 10 second period before reaching a more constant Tachycardia
- In contrast, microreentry mechanisms start and stop abruptly
- Contrast with Sinus Tachycardia which ramps up more slowly and responds to physiologic measures (e.g. IV fluids)
VI. Types
- Atrial Tachycardia
- Focal
- Microreentry
- Multifocal Atrial Tachycardia
- Irregular narrow complex rhythm with 3 or more different P Wave morphologies
VII. Causes: Multifocal Atrial Tachycardia
- Causes: Enlarged atrium
- Chronic lung disease
- Congestive Heart Failure
- Causes: Other
- Acid-base disturbance
- Electrolyte abnormalities
VIII. Management: Focal Atrial Tachycardia
- Catheter Ablation Indications
- Recurrent Focal Atrial Tachycardia
- Secondary Cardiomyopathy due to Atrial Tachycardia
- Medical Management
- Beta Blocker (e.g. Metoprolol)
- Nondihydropyridine Calcium Channel Blocker (e.g. Diltiazem)
- Contraindicated in Congestive Heart Failure
- Antiarrhythmics (Propafenone, Flecainide)
- Indicated in ischemic or structural heart disease
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Related Studies
| Definition (NCI) | An electrocardiographic finding of a supraventricular arrhythmia characterized by 3 or more distinct P wave morphologies with an isoelectric baseline, variable PR intervals and no predominant atrial rhythm. The ventricular rate is typically 100-150 beats per minute. (CDISC) |
| Definition (NCI_CDISC) | An electrocardiographic finding of a supraventricular arrhythmia characterized by 3 or more distinct P wave morphologies with an isoelectric baseline, variable PR intervals and no predominant atrial rhythm. The ventricular rate is typically 100-150 beats per minute. |
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 49982000 |
| Dutch | multifocale atriumtachycardie |
| French | Tachycardie auriculaire multifocale |
| German | multifokale Vorhoftachykardie |
| Italian | Tachicardia atriale multifocale |
| Portuguese | Taquicardia auricular multifocal |
| Spanish | Taquicardia auricular multifocal, taquicardia auricular multifocal (trastorno), taquicardia auricular multifocal |
| Japanese | 多源性心房頻脈, ﾀｹﾞﾝｾｲｼﾝﾎﾞｳﾋﾝﾐｬｸ |
| English | multifocal atrial tachycardia, multifocal atrial tachycardia (diagnosis), Multifocal Atrial Tachycardia, MULTIFOCAL ATRIAL TACHYCARDIA, Multifocal Atrial Tachycardia by ECG Finding, Multifocal Atrial Tachycardia by EKG Finding, Multifocal atrial tachycardia, Multifocal atrial tachycardia (disorder) |
| Czech | Multifokální síňová tachykardie |
| Hungarian | Multifocalis pitvari tachycardia |
Ontology: Atrial tachycardia (C0546959)
| Definition (NCI) | A disorder characterized by an electrocardiographic finding of an organized, regular atrial rhythm with atrial rate between 101 and 240 beats per minute. The P wave morphology must be distinct from the sinus P wave morphology. (CDISC) |
| Concepts | Pathologic Function (T046) |
| SnomedCT | 276796006, 23899004 |
| English | TACHYCARDIA ATRIAL, Atrial tachycardia, Tachycardia atrial, atrial tachycardias, tachycardia atrial, atrial tachycardia (diagnosis), atrial tachycardia, ATRIAL TACHYCARDIA, Atrial tachycardia (disorder), atrium; tachycardia, auricular; tachycardia, tachycardia; atrial, tachycardia; auricular, Atrial tachycardia, NOS, Atrial Tachycardia |
| Italian | Tachicardia atriale |
| French | Tachycardie auriculaire, TACHYCARDIE AURICULAIRE, Tachysystolie auriculaire |
| German | Tachykardie Vorhof, TACHYKARDIE VORHOF, Vorhoftachykardie |
| Japanese | 心房頻脈, ｼﾝﾎﾞｳﾋﾝﾐｬｸ |
| Portuguese | TAQUICARDIA AURICULAR, Taquicardia auricular |
| Spanish | TAQUICARDIA AURICULAR, taquicardia auricular (trastorno), taquicardia auricular, Taquicardia auricular |
| Czech | Síňová tachykardie, Tachykardie síňová |
| Hungarian | Pitvari tachycardia |
| Dutch | atrium; tachycardie, auriculair; tachycardie, tachycardie; atrium, tachycardie; auriculair, atriumtachycardie |
