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Atrial tachycardia

Medically reviewed on Aug 2, 2018

Overview

Atrial tachycardia is the least common type of supraventricular tachycardia. It's generally seen in children with underlying heart disorders such as congenital heart disease, particularly those who've had heart surgery.

Atrial tachycardia may also be triggered by factors such as an infection or drug or alcohol use. For some people, atrial tachycardia increases during pregnancy or exercise.

Atrial tachycardia episodes typically begin slowly, gradually increasing to more than 100 beats per minute before returning to a normal heart rate of around 60 to 80 beats per minute. In some cases, these episodes occur more abruptly or occur continuously.

Diagnosis

Tests and procedures used to diagnose atrial tachycardia may include:

  • Blood tests to check thyroid function, heart disease or other conditions that may trigger atrial tachycardia
  • Electrocardiogram (ECG) to measure the electrical activity of your heart and measure the timing and duration of each heartbeat
  • Holter monitor, which is a portable ECG device designed to record your heart's activity as you go about your routine
  • Echocardiogram, which uses sound waves to produce images of your heart's size, structure and motion

Your doctor might also try to trigger an episode with other tests, which may include:

  • Stress test, which is typically done on a treadmill or stationary bicycle while your heart activity is monitored
  • Electrophysiological testing and mapping, which allows your doctor to see the precise location of the arrhythmia

Treatment

Treatment of atrial tachycardia depends on the severity of the condition and the factors that trigger it. In addition to managing any underlying conditions that could trigger your atrial tachycardia, your doctor may recommend or try:

  • Vagal maneuvers. You may be able to temporarily slow your heart rate by using particular maneuvers that include holding your breath and straining, dunking your face in ice water, or coughing.
  • Medications. Your doctor may suggest intravenous or oral medication to control your heart rate or restore a normal heart rhythm.
  • Cardioversion. If your arrhythmia (irregular heart beat) does not respond to vagal maneuvers or medication — and if there's no identifiable, treatable condition triggering it to occur — your doctor may use electrical cardioversion. In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
  • Catheter ablation. In some cases, your doctor may recommend catheter ablation. For this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.
  • Pacemaker. If you experience frequent episodes of atrial tachycardia and all other treatment options are unsuccessful, your doctor may suggest implanting a small device called a pacemaker to emit electrical impulses that stimulate your heart to beat at a normal rate. For people with atrial tachycardia, this procedure is typically followed by an ablation of the AV node.

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