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Atrial Tachycardia


What is atrial tachycardia?

Atrial tachycardia (AT) is a condition that causes your heart to beat 100 to 300 times each minute. A normal heart rate at rest is 60 to 80 beats each minute. AT develops because of problems with your heart's electrical system. Your atria (top chambers) may send electrical signals that increase your heart rate, or the pathway of the electrical signal may be blocked. Your heart keeps sending signals to try to get past the block.

What increases my risk of atrial tachycardia?

Your risk for AT increases as you age, or if a close family member has AT. Your AT may only occur or worsen when you are active. The following may also increase your risk:

  • Electrolyte imbalance: Electrolytes are minerals that help your heart function correctly. Dehydration, vomiting, or diarrhea can cause an electrolyte imbalance. You may develop AT if you have low levels of the electrolytes potassium and magnesium, or high calcium levels.
  • Alcohol, caffeine, nicotine, and drugs: These substances can increase your heart rate or cause dehydration.
  • Medical conditions: An infection can increase your risk for AT. Hyperthyroidism (too much thyroid hormone) can lead to AT because thyroid hormone helps control your heartbeat. Heart failure or a heart attack can increase your risk. Lung conditions including pulmonary edema or chronic lung disease may also increase your risk.
  • Medicines: Too much of certain medicines in your blood, such as digoxin, can lead to AT. Digoxin is a heart medicine used to help your heart work better. Medicines to treat cancer may also increase your risk.
  • Cardiac ablation: AT may occur after cardiac ablation to treat atrial fibrillation (350 to 600 heartbeats each minute).
  • Heart surgery: Surgery such as heart valve replacement and coronary artery bypass grafting may lead to AT.

What are the signs and symptoms of atrial tachycardia?

You may feel any of the following:

  • Lightheaded, dizzy, or faint
  • Jumping or fluttering in your chest
  • More tired than usual
  • New or increased shortness of breath
  • Pain, pressure, or tightness in your chest
  • The need to urinate more often than usual

How is atrial tachycardia diagnosed?

Your healthcare provider will ask about your symptoms and listen to your heart. Tell him how often you have symptoms, and if they change during the day. Tell him if you are taking any medicines. You may also need any of the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • ECG: This is also called an EKG. An ECG is done to check for damage or problems in your heart. A short period of electrical activity in your heart is recorded.
  • Holter monitor: A Holter monitor is also called an ambulatory ECG monitor. It is a device that you wear while you do your usual activities. The monitor shows your heart's electrical activity, how fast it beats, and if it beats in a regular pattern.
  • Electrophysiologic study: An electrophysiologic study is used to chart the electrical pathways in your heart that control your heartbeat. Wires are guided through a blood vessel in your arm, neck, chest, or groin to your heart. Readings are taken through the wires. Your healthcare provider can also use these wires to trigger your heart rhythm problem.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.
  • Exercise stress test: An exercise stress test helps healthcare providers see the changes that take place in your heart during exercise. The test is done while you ride an exercise bike or walk on a treadmill. Healthcare providers will ask if you have chest pain or trouble breathing during the test.

How is atrial tachycardia treated?

  • Vagal maneuvers: Vagal maneuvers (methods) can help slow the signal from your atria and stop your AT. An example of a vagal maneuver is putting your face in ice cold water. Your healthcare provider may teach you other vagal maneuvers to do on your own when you have an episode of AT.
  • Medicines:
    • Antiarrhythmias: These help slow your heartbeat and make it more normal.
    • Beta blockers: These help keep your heartbeat in a regular rhythm.
    • Calcium channel blockers: These help slow your heartbeat.
    • Blood thinners: These help prevent blood clots. Clots can lead to stroke, heart attack, and death. Aspirin is a type of blood thinner. You may need to take an aspirin each day to help prevent blood clots. Do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than healthcare providers say to take. If you are on other blood thinner medicine, ask your healthcare provider before you take aspirin for any reason.
    • Electrolytes: You may be given electrolytes in the hospital if an electrolyte imbalance caused your AT.
  • Cardioversion: This is a procedure where an electric shock is given to your heart. The shock is usually given through paddles or sticky patches placed on your chest or back. The shock helps your heart return to a normal beat. Cardioversion may be needed if medicine does not make your heart work better. You may need a cardioversion if your heart rhythm is making you sick or is dangerous. You may be given medicine to help you relax before getting the electric shock. If the shock works, your heart rate and rhythm will return to normal. Medicine may be needed to keep your heart in a normal rhythm. You may need a cardioversion more than once.
  • Cardiac ablation: Cardiac ablation is a procedure that uses heat energy to stop abnormal heart impulses. A wire is guided to your heart through an artery or a vein. Your healthcare provider finds the area of the heart that is causing the problems and applies heat energy to it. This may help your heart beat in a more regular rhythm.
  • Pacemaker: This is a machine that helps your heart beat at a normal speed and in a regular rhythm. If your heart does not beat as it should, the pacemaker sends small electric signals to your heart. You may feel these signals.
    • Temporary: Large patches are placed on your chest and back. The patches are connected to a monitor. Your healthcare provider may need to put small wires through your skin and into your heart muscle instead. The wires are connected to a small pacemaker box outside of your body.
    • Permanent: A permanent pacemaker is about the size of a wristwatch. It is implanted under the skin of your chest.
  • Surgery: You may need surgery if other treatments do not work to stop your AT.

How can I manage my atrial tachycardia?

  • Avoid alcohol and caffeine: Alcohol and caffeine increase your risk for AT and for palpitations (fast, forceful heartbeats).
  • Do not smoke or use drugs: Drugs such as meth, and the nicotine in cigarettes can make your heartbeat faster. Talk to your healthcare provider if you smoke or use illegal drugs and need help to stop.
  • Ask about sports: You may have to limit or stop playing sports while your AT is treated. Ask your healthcare provider if it is safe for you to play sports.
  • Prevent pregnancy: During pregnancy and childbirth, the mother's heart works harder than usual. Talk with your healthcare provider about safe ways to prevent pregnancy. If you do get pregnant, make sure your healthcare provider knows you have AT. Your medicines may need to be changed while you are pregnant. Some medicines can lead to health problems for you and your unborn baby.

What are the risks of atrial tachycardia?

  • Medicines to treat your AT may cause your heart to beat too slowly or your blood pressure to drop. Certain medicines may cause other types of heartbeat problems. Cardiac ablation can cause you to bleed, bruise, or get an infection where the wire was put in. Even after treatment, your AT and symptoms may return, and you may need more treatments.
  • Without treatment, your symptoms may get worse. Your heart may not be able to pump enough blood to supply oxygen to the rest of your body. You may get a blood clot. The clot can break loose and travel to your lungs or brain. A blood clot can cause you to have a stroke. Your heart may weaken and not work properly. You are also at a higher risk for a heart attack and heart failure.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • You are feeling more tired than usual.
  • You have new or increased palpitations.
  • Your heart is skipping beats.
  • You are urinating more often than usual.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have pain, pressure, or fullness in your chest that lasts more than a few minutes or returns.
  • You have pain or discomfort in your back, neck, jaw, stomach, or arm.
  • You have an upset stomach.
  • You have a sudden cold sweat.
  • You suddenly feel lightheaded and are short of breath. You have more pain when you take deep breaths or cough. You cough up blood.
  • You have a painful red lump in your arm or leg.
  • You have weakness or numbness in your arm, leg, or face.
  • You are confused or have problems speaking or understanding speech.
  • You have a severe headache or feel dizzy.
  • You have vision changes or loss of vision.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.