Materiały źródłowe

• #1 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Atrial tachycardia is a heart rhythm in which the heart beats faster than 100 beats per minute due to an electrical signal in the atria. It is one type of paroxysmal supraventricular tachycardia (PSVT), a term referring to a group of arrhythmias that originate above the atrioventricular junction (AVJ) and that generally begin and end abruptly. […] Collectively, the PSVTs are thought to affect 36 per 100,000 persons per year in the United States. Women are at twice the risk of PSVT compared to men, while older people face a fivefold risk compared with younger people. […] Of all PSVTs, atrial tachycardia is the least common, accounting for approximately 1 in 10 cases. Among patients referred for supraventricular tachycardia (SVT) ablation, focal atrial tachycardia (FAT) is present in 3% to 17%.

• #2 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  The differential diagnosis of narrow-complex tachycardias, including the PSVTs, is important because treatment differs depending on the arrhythmia. This requires scrutiny of the ECG with close attention to P-wave and QRS shapes and to the PR and RR intervals. […] Prognosis depends on the underlying cause. Unifocal atrial tachycardia is usually benign in adults and may not require treatment if it is not sustained. On the other hand, incessant atrial tachycardia can contribute directly to tachycardic cardiomyopathy and reversible heart failure. […] Atrial tachycardia is a form of tachyarrhythmia, a heart rhythm in which the heart beats faster than 100 beats per minute due to an electrical signal in the atria. Atrial tachycardia is a type of paroxysmal supraventricular tachycardia (PSVT), a group of arrhythmias that originate above the atrioventricular junction (AVJ).

• #3 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Atrial tachycardia is a heart rhythm in which the heart beats faster than 100 beats per minute due to an electrical signal in the atria. It is one type of paroxysmal supraventricular tachycardia (PSVT), a term referring to a group of arrhythmias that originate above the atrioventricular junction (AVJ) and that generally begin and end abruptly. […] Collectively, the PSVTs are thought to affect 36 per 100,000 persons per year in the United States. Women are at twice the risk of PSVT compared to men, while older people face a fivefold risk compared with younger people. […] Of all PSVTs, atrial tachycardia is the least common, accounting for approximately 1 in 10 cases. Among patients referred for supraventricular tachycardia (SVT) ablation, focal atrial tachycardia (FAT) is present in 3% to 17%.

• #4 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #5 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #6 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #7 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  A healthcare provider can diagnose atrial tachycardia when you have symptoms of a heart rhythm problem. Typically, theyll want to get an electrocardiogram (EKG), which involves attaching stickers to your chest and obtaining a printout of your heart rhythm at that time. […] Other tests include wearing a small monitor for a period of time to catch the abnormal rhythm. If the suspicion is high for atrial tachycardia but noninvasive tests have failed to prove this, your provider may take you into the lab under sedation and place catheters in your heart to detect and/or induce this abnormal rhythm. […] The following tests are often used to diagnose atrial tachycardia: Physical exam: This is the type of exam you get during an annual physical. Your provider may hear a fast heart rhythm even if you have no other symptoms. Most providers will also review your medical history to see if you have any risk factors for this condition.

• #8 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #9 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  Electrocardiography (ECG or EKG): This test measures your hearts electrical activity using sensors attached to the skin of your chest. You can get this test in minutes at a healthcare facility. […] Holter monitor: This is similar to an electrocardiogram but records heart activity over a few days or weeks. You take this device home with you and return it after the set recording period ends. […] Ambulatory monitors: These devices function like an electrocardiogram. However, you take them home and wear them for up to 30 days. Some monitors track your hearts activity constantly but only record the data when you activate the device. Others can activate themselves when they detect an abnormal rhythm. […] Electrophysiology study: This is a procedure that maps and measures the electrical activity of your heart. This can show areas where electrical activity in your heart isnt happening as it should.

• #10 Atrial tachycardia: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/atrial-tachycardia

  Atrial tachycardia is an arrhythmia with a heart rate greater than 100 beats per minute that originates in the atria, or upper chambers, of the heart. […] A doctor can diagnose atrial tachycardia by monitoring the heart rate and electrical signals in the heart. This usually begins with an electrocardiogram (ECG), which measures electrical patterns in the heart. […] Sometimes, an ECG may indicate a typical heart rate because the heart is not currently in an arrhythmia. Longer-term monitoring may help detect an arrhythmia. […] A healthcare professional may also order other diagnostic tests to determine the underlying cause of atrial tachycardia. These may include: echocardiogram, stress testing, heart catheterization. […] Anyone who experiences symptoms of atrial tachycardia should speak with a healthcare professional. A doctor can conduct diagnostic tests and recommend appropriate treatment if necessary.

• #11 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #12 Atrial tachycardia: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/atrial-tachycardia

  Atrial tachycardia is an arrhythmia with a heart rate greater than 100 beats per minute that originates in the atria, or upper chambers, of the heart. […] A doctor can diagnose atrial tachycardia by monitoring the heart rate and electrical signals in the heart. This usually begins with an electrocardiogram (ECG), which measures electrical patterns in the heart. […] Sometimes, an ECG may indicate a typical heart rate because the heart is not currently in an arrhythmia. Longer-term monitoring may help detect an arrhythmia. […] A healthcare professional may also order other diagnostic tests to determine the underlying cause of atrial tachycardia. These may include: echocardiogram, stress testing, heart catheterization. […] Anyone who experiences symptoms of atrial tachycardia should speak with a healthcare professional. A doctor can conduct diagnostic tests and recommend appropriate treatment if necessary.

• #13 Atrial Tachycardia Diagnosis & Treatment in Birmingham | Rapid Heartbeat

  https://www.stop-af.com/about-your-rhythm/atrial-tachycardia/

  Atrial tachycardia (AT) is a type of heart arrhythmia that causes your heart to beat 100 to 300 times each minute. […] Dr. Smith can diagnose atrial tachycardia in his office with an electrocardiogram (ECG/EKG), but when the elevated heart rates are only occasional occurrences, the ECG may show normal results. […] In these cases, Dr. Smith will have you wear an ECG monitor at home. This will record your heart rhythm over time. […] Blood tests can be used to check thyroid function, heart disease, and other conditions that can trigger atrial tachycardia. […] Stress tests done on a treadmill or stationary bike can also be used to monitor heart activity.

• #14 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  Electrocardiography (ECG or EKG): This test measures your hearts electrical activity using sensors attached to the skin of your chest. You can get this test in minutes at a healthcare facility. […] Holter monitor: This is similar to an electrocardiogram but records heart activity over a few days or weeks. You take this device home with you and return it after the set recording period ends. […] Ambulatory monitors: These devices function like an electrocardiogram. However, you take them home and wear them for up to 30 days. Some monitors track your hearts activity constantly but only record the data when you activate the device. Others can activate themselves when they detect an abnormal rhythm. […] Electrophysiology study: This is a procedure that maps and measures the electrical activity of your heart. This can show areas where electrical activity in your heart isnt happening as it should.

• #15 Tachycardia: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/what-are-the-types-of-tachycardia

  Tachycardia Diagnosis […] To find out whether you have tachycardia, your doctor may order different kinds of tests. They include: […] Electrocardiogram (EKG). This records the electrical activity in your heart and helps your doctor search for things that don’t look normal. You may have to wear a Holter monitor, a portable machine that records your EKG signals over 24 hours. […] Event monitor. This is like a Holter monitor, but it records only a few minutes at a time several times a day. You might need to wear it for 30 days. When you feel symptoms, you might push a button to start the measurement. Or the device may detect changes in your heart rhythm and record automatically. […] Exercise stress test. Your doctor will have you walk on a treadmill while they monitor your heart activity.

• #16 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  Electrocardiography (ECG or EKG): This test measures your hearts electrical activity using sensors attached to the skin of your chest. You can get this test in minutes at a healthcare facility. […] Holter monitor: This is similar to an electrocardiogram but records heart activity over a few days or weeks. You take this device home with you and return it after the set recording period ends. […] Ambulatory monitors: These devices function like an electrocardiogram. However, you take them home and wear them for up to 30 days. Some monitors track your hearts activity constantly but only record the data when you activate the device. Others can activate themselves when they detect an abnormal rhythm. […] Electrophysiology study: This is a procedure that maps and measures the electrical activity of your heart. This can show areas where electrical activity in your heart isnt happening as it should.

• #17 Tachycardia: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/what-are-the-types-of-tachycardia

  Tachycardia Diagnosis […] To find out whether you have tachycardia, your doctor may order different kinds of tests. They include: […] Electrocardiogram (EKG). This records the electrical activity in your heart and helps your doctor search for things that don’t look normal. You may have to wear a Holter monitor, a portable machine that records your EKG signals over 24 hours. […] Event monitor. This is like a Holter monitor, but it records only a few minutes at a time several times a day. You might need to wear it for 30 days. When you feel symptoms, you might push a button to start the measurement. Or the device may detect changes in your heart rhythm and record automatically. […] Exercise stress test. Your doctor will have you walk on a treadmill while they monitor your heart activity.

• #18 Living with supraventricular tachycardia: from diagnosis to treatment | Spire Healthcare

  https://www.spirehealthcare.com/health-hub/specialties/heart-health/living-with-supraventricular-tachycardia-from-diagnosis-to-treatment/

  Getting a diagnosis of SVT can be challenging. This is because your doctor will need an ECG that shows the rhythm of your heart during an episode of SVT. If your episodes are infrequent and last only a few seconds or minutes, this can be difficult to capture. However, advances in heart monitoring technology mean that it is getting easier. […] If you have symptoms of SVT, your doctor may recommend having your heart rhythm recorded using a wearable heart monitor. In the past, heart monitors could only record heart rhythms for 24-48 hours. However, today, newer devices such as the Zio XT patch offer heart monitoring for up to two weeks using wire-free patches. The ability to monitor the heart for longer periods makes it more likely that an episode of SVT will be captured. […] For longer-term heart monitoring, you can have a loop recorder implanted just under your skin on the left side of your chest. This can monitor your heart rhythm for up to three years.

• #19 Device-Detected Atrial Tachycardia and Risk of Thromboembolism

  https://www.acc.org/latest-in-cardiology/articles/2017/02/03/09/44/device-detected-atrial-tachycardia-and-risk-of-thromboembolism

  Studies have shown that longer term cardiac monitoring correlates with a higher rate of diagnosis of AF. The sensitivity of AT or AF detection longer than five minutes in patients with history of brady-tachy syndrome was 44.4%, 50.4%, and 65.1% for 24-hour, 1-week, and 1-month monitoring periods with dual-chamber pacemakers, respectively. Similar findings have also been shown with wearable event recorders and implantable cardiac monitors (ICMs). In patients with cryptogenic stroke and negative ECG and 24-holter monitors, the overall yield of AT/AF detection ranged from 6% with 7-day monitors, 11-23% with 30-day monitors, and up to 27.3-28% in patients 1-year ICMs. […] Although an increased risk of TE and AT/AF has been shown in multiple studies, a clear temporal correlation of AT/AF with subsequent risk of CVA or TIA has not yet been elucidated. Multiple studies have shown significant associations between relatively low overall AT burdens and risk of CVA or TIA. A sub-analysis of the Mode Selection Trial (MOST), which evaluated outcomes in 312 patients, noted a 2.79-fold increase in risk of death or nonfatal stroke associated with patients with greater than 5 minutes of recorded AT. In 2009, the TRENDS study (A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics) examined a larger cohort of 3,045 patients with cardiac monitoring devices and at least one CHADS2 score criteria. It showed that an AT burden of greater than 5.5 hours conferred a doubling in the risk of TE event, but the results were weakly powered as the rate of TE in the study population was low. More recently, the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial (ASSERT) trial described outcomes in a prospectively assembled cohort of 2,580 patients greater than 65-years-old with medically-treated hypertension, placement of pacemaker or ICD, on no anticoagulation, and with no prior TE events. Results indicated that patients with even 6 minutes of AT had a markedly increased risk of ischemic stroke or systemic embolism (hazard ratio, 2.49; 95% CI, 1.28 to 4.85; P = 0.007). Finally, in 2014, a pooled analysis of 3 prospective observational studies, totaling 10,016 patients (including the TRENDS study), noted a two-fold increase in CVA or TIA risk in patients with a daily AF burden of 5 minutes or greater.

• #20 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  In atrial tachycardia, the AVJ is not part of the circuit. This distinguishes it from related arrhythmias such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardias (AVRT). […] There are two main types of atrial tachycardia: unifocal and multifocal. […] Symptoms of paroxysmal supraventricular tachycardia commonly include palpitations, chest pain, fatigue, and/or lightheadedness. Syncope is less common, while sudden cardiac death may rarely occur. […] An electrocardiogram (ECG) reveals a regular, narrow-complex tachycardia in which P waves differ from their appearance in sinus rhythm. P waves may sometimes disappear into the preceding T waves. […] Because bouts of tachycardia can be short-lived and episodic, the patient may not be experiencing symptoms during the clinical encounter. The history should elicit a description of episodes, including any triggers; if the episodes occur with activity or amid known heart disease, a ventricular origin may be present.

• #21 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  For unifocal tachycardia, ECG shows a fast, regular rhythm with isoelectric segments between P-waves. It may be difficult to distinguish from other regular SVTs. The P waves outnumber the QRS complexes, helping to distinguish atrial tachycardia from sinus tachycardia. […] With MAT, the ECG shows an irregular rhythm with at least three different P-wave morphologies, typically with isoelectric periods between them. […] Some diagnostics can also be therapeutic. Vagal maneuvers such as the Valsalva maneuver or unilateral carotid sinus massage can slow down conduction through the atrioventricular node. […] Pharmacological interventions such as adenosine, which should be administered in a monitored environment, can also block atrioventricular conduction. If the arrhythmia stops in response to adenosine, it indicates AVNRT or AVRT.

• #22 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Abrupt onset of tachycardia is indicative of atrial tachycardia while gradual onset is suggestive of sinus tachycardia. In unifocal tachycardia, the P-waves outnumber the QRS complexes, which helps to differentiate atrial tachycardia from sinus tachycardia. […] The prognosis of MAT will relate in large part to underlying lung disease. Treatment for paroxysmal supraventricular tachycardia includes a variety of antiarrhythmic drugs and/or catheter ablation of the abnormal focus or foci. Unifocal atrial tachycardia may respond to medication; ablation with 3-dimensional mapping technology is frequently successful. […] Atrial tachycardia and the other PSVTs may be misdiagnosed as panic disorder or anxiety disorder, which may be hazardous if an incessant arrhythmia is overlooked.

• #23 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Abrupt onset of tachycardia is indicative of atrial tachycardia while gradual onset is suggestive of sinus tachycardia. In unifocal tachycardia, the P-waves outnumber the QRS complexes, which helps to differentiate atrial tachycardia from sinus tachycardia. […] The prognosis of MAT will relate in large part to underlying lung disease. Treatment for paroxysmal supraventricular tachycardia includes a variety of antiarrhythmic drugs and/or catheter ablation of the abnormal focus or foci. Unifocal atrial tachycardia may respond to medication; ablation with 3-dimensional mapping technology is frequently successful. […] Atrial tachycardia and the other PSVTs may be misdiagnosed as panic disorder or anxiety disorder, which may be hazardous if an incessant arrhythmia is overlooked.

• #24 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  For unifocal tachycardia, ECG shows a fast, regular rhythm with isoelectric segments between P-waves. It may be difficult to distinguish from other regular SVTs. The P waves outnumber the QRS complexes, helping to distinguish atrial tachycardia from sinus tachycardia. […] With MAT, the ECG shows an irregular rhythm with at least three different P-wave morphologies, typically with isoelectric periods between them. […] Some diagnostics can also be therapeutic. Vagal maneuvers such as the Valsalva maneuver or unilateral carotid sinus massage can slow down conduction through the atrioventricular node. […] Pharmacological interventions such as adenosine, which should be administered in a monitored environment, can also block atrioventricular conduction. If the arrhythmia stops in response to adenosine, it indicates AVNRT or AVRT.

• #25 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Drugs that can cause atrial tachycardia include digoxin and theophylline. Other medications include -adrenergic agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also precipitate an atrial arrhythmia. […] Unifocal type, otherwise known as focal atrial tachycardia occurs as a result of either automaticity of an atrial ectopic site or reentry. The ECG is that of sinus tachycardia, with a P wave before each QRS complex. But the morphology of the P-wave is different from that of sinus rhythm, demonstrating depolarization of the atrium from an atypical location. […] In multifocal atrial tachycardia (MAT), the ECG shows an irregular rhythm with at least 3 different P-wave morphologies, and the average atrial rate is 100 beats/min. This rhythm most often occurs in the setting of severe pulmonary disease or hypomagnesemia.

• #26 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #27 Multifocal Atrial Tachycardia (MAT) • LITFL • ECG Library Diagnosis

  https://litfl.com/multifocal-atrial-tachycardia-mat-ecg-library/

  A rapid, irregular atrial rhythm arising from multiple ectopic foci within the atria. […] Most commonly seen in patients with severe COPD or congestive heart failure. […] It is typically a transitional rhythm between frequent premature atrial complexes (PACs) and atrial flutter / fibrillation. […] At least 3 distinct P-wave morphologies in the same lead. […] Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent PACs). […] Usually occurs in seriously ill elderly patients with respiratory failure (e.g. exacerbation of COPD / CHF). […] Tends to resolve following treatment of the underlying disorder. […] The development of MAT during an acute illness is a poor prognostic sign, associated with a 60% in-hospital mortality and mean survival of just over a year. Death occurs due to the underlying illness; not the arrhythmia itself. […] The net result is increased atrial automaticity.

• #28 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  For unifocal tachycardia, ECG shows a fast, regular rhythm with isoelectric segments between P-waves. It may be difficult to distinguish from other regular SVTs. The P waves outnumber the QRS complexes, helping to distinguish atrial tachycardia from sinus tachycardia. […] With MAT, the ECG shows an irregular rhythm with at least three different P-wave morphologies, typically with isoelectric periods between them. […] Some diagnostics can also be therapeutic. Vagal maneuvers such as the Valsalva maneuver or unilateral carotid sinus massage can slow down conduction through the atrioventricular node. […] Pharmacological interventions such as adenosine, which should be administered in a monitored environment, can also block atrioventricular conduction. If the arrhythmia stops in response to adenosine, it indicates AVNRT or AVRT.

• #29 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #30 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  For unifocal tachycardia, ECG shows a fast, regular rhythm with isoelectric segments between P-waves. It may be difficult to distinguish from other regular SVTs. The P waves outnumber the QRS complexes, helping to distinguish atrial tachycardia from sinus tachycardia. […] With MAT, the ECG shows an irregular rhythm with at least three different P-wave morphologies, typically with isoelectric periods between them. […] Some diagnostics can also be therapeutic. Vagal maneuvers such as the Valsalva maneuver or unilateral carotid sinus massage can slow down conduction through the atrioventricular node. […] Pharmacological interventions such as adenosine, which should be administered in a monitored environment, can also block atrioventricular conduction. If the arrhythmia stops in response to adenosine, it indicates AVNRT or AVRT.

• #31 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  For unifocal tachycardia, ECG shows a fast, regular rhythm with isoelectric segments between P-waves. It may be difficult to distinguish from other regular SVTs. The P waves outnumber the QRS complexes, helping to distinguish atrial tachycardia from sinus tachycardia. […] With MAT, the ECG shows an irregular rhythm with at least three different P-wave morphologies, typically with isoelectric periods between them. […] Some diagnostics can also be therapeutic. Vagal maneuvers such as the Valsalva maneuver or unilateral carotid sinus massage can slow down conduction through the atrioventricular node. […] Pharmacological interventions such as adenosine, which should be administered in a monitored environment, can also block atrioventricular conduction. If the arrhythmia stops in response to adenosine, it indicates AVNRT or AVRT.

• #32 Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P‐Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6931826/

  In order to correctly differentiate an AT from other NCTs, we propose a simple diagnostic algorithm with a step-by-step approach. […] Holter analysis could offer further details to discriminate between AT and another SVT. […] Whenever there is an SVT without visible P waves and without undulating pattern, it may be: 1:1 or 2:1 AT, common AVNRT, orthodromic AVRT, or JT. […] If the diagnosis is uncertain, it is possible to utilize vagal maneuvers, such as sinus carotid massage, or adenosine administration. […] A good knowledge and interpretation of the ECG could help the physician to differentiate focal and macroreentrant AT from the other SVTs and to manage and to treat correctly these patients.

• #33 Atrial Tachycardia – Cardio Guide

  https://www.cardioguide.ca/atrial-tachycardia/

  Response To Adenosine: Adenosine blocks the AV node, which stops ventricular activation, revealing AT P-waves. Compare these P-waves to the sinus ECG. Usually P-waves are discrete and separated by an isoeletric period. Tachycardia continues after adenosine effect wears off. NOTE: Some atrial tachycardias are adenosine-sensitive, and can slow down or terminate with adenosine. […] Localizing Atrial Origin (Advanced): Negative P wave in lead I and aVL suggests LA origin. V1 is negative lateral RA. V1 is biphasic or positive Septal RA and LA. Negative in inferior leads Inferior origin. Positive in inferior leads Superior origin. […] Acute Therapy: If unstable Cardioversion (Class IA). Identify and treat associated conditions: LA stretch (HF, CMP, HTN), MI, PE, infection, alcohol, electrolytes, cocaine/stimulants, theophyline. Adenosine (IIA) rarely work. Adenosine can convert DAD-triggered AT. B-Blockers (IIA) can terminate or slow the rate. Avoid in decompensated HF. Metoprolol 2.5-5mg IV over 2-5min (max 15mg). CCB (IIA) avoid in Hypotension and HFrEF. Diltiazem 20mg IV bolus over 2min, repeat q15min. Verapamil: 5-10mg IV over 2min. Additional 10mg IV can be given after 15-30min.

• #34 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  A healthcare provider can diagnose atrial tachycardia when you have symptoms of a heart rhythm problem. Typically, theyll want to get an electrocardiogram (EKG), which involves attaching stickers to your chest and obtaining a printout of your heart rhythm at that time. […] Other tests include wearing a small monitor for a period of time to catch the abnormal rhythm. If the suspicion is high for atrial tachycardia but noninvasive tests have failed to prove this, your provider may take you into the lab under sedation and place catheters in your heart to detect and/or induce this abnormal rhythm. […] The following tests are often used to diagnose atrial tachycardia: Physical exam: This is the type of exam you get during an annual physical. Your provider may hear a fast heart rhythm even if you have no other symptoms. Most providers will also review your medical history to see if you have any risk factors for this condition.

• #35 Atrial Tachycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia

  Electrocardiography (ECG or EKG): This test measures your hearts electrical activity using sensors attached to the skin of your chest. You can get this test in minutes at a healthcare facility. […] Holter monitor: This is similar to an electrocardiogram but records heart activity over a few days or weeks. You take this device home with you and return it after the set recording period ends. […] Ambulatory monitors: These devices function like an electrocardiogram. However, you take them home and wear them for up to 30 days. Some monitors track your hearts activity constantly but only record the data when you activate the device. Others can activate themselves when they detect an abnormal rhythm. […] Electrophysiology study: This is a procedure that maps and measures the electrical activity of your heart. This can show areas where electrical activity in your heart isnt happening as it should.

• #36 Atrial Tachycardia: Diagnosis and Treatment – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/cardiology/atrial-tachycardia-diagnosis-and-treatment/

  An atrial tachycardia is a fast abnormal heart rhythm in which the electrical impulse originates in atrial tissue different than the sinoatrial node. […] A definitive diagnosis of an atrial tachycardia may be only possible through specific clinical or electrophysiologic features of the arrhythmia requiring electrocardiography and sometimes even intracardiac recordings. […] The diagnostic confirmation of an atrial tachycardia requires detailed analysis of electrocardiographic or intracardiac electrogram recordings. Definitive diagnosis can be suspected but not confirmed in clinical grounds only. […] Sudden onset and offset of a regular narrow complex (QRS 120 ms) tachycardia coincidental with the presenting symptoms is very suggestive of a supraventricular tachycardia. […] A long PR interval during tachycardia does not exclude an atrial tachycardia since atrial tachycardias conducted either over the slow pathway of the AV node, a diseased AV node, or an AV node slowed by drugs or increased vagal tone could result in a prolonged PR interval during the arrhythmia.

• #37 Atrial Tachycardia: Diagnosis and Treatment – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/cardiology/atrial-tachycardia-diagnosis-and-treatment/

  The diagnosis of supraventricular tachycardias and specifically atrial tachycardias is established with the documentation and characterization of the heart rhythm as discussed in section II E 2 below. […] The definitive diagnosis confirmation of an atrial tachycardia is best done in the electrophysiology laboratory. Intracardiac recordings and response to pacing maneuvers during tachycardia, as well as characteristics of tachycardia induction and activation maps, provide a definitive diagnosis of the mechanism of the tachycardia as well as an opportunity for definitive treatment through ablation.

• #38 Atrial Tachycardia: Causes, Symptoms, and Treatment

  https://www.medicoverhospitals.in/diseases/atrial-tachycardia/

  Accurate diagnosis is essential for the effective management of atrial tachycardia. Several diagnostic tools and tests are employed to identify this condition. […] An ECG is a primary diagnostic tool that records the electrical activity of the heart. It can help identify abnormal rhythms indicative of atrial tachycardia. […] A Holter monitor is a portable ECG device worn by the patient for 24 to 48 hours. It provides a continuous record of heart activity, capturing intermittent episodes of atrial tachycardia. […] Similar to a Holter monitor, an event monitor is worn for an extended period. Patients activate it during symptomatic episodes, allowing for targeted recording. […] An EPS involves inserting catheters into the heart to map its electrical activity. This invasive procedure can pinpoint the exact location of abnormal electrical impulses. […] Diagnosis involves an electrocardiogram (ECG), Holter monitor, and sometimes an electrophysiology study to assess the heart’s electrical activity.

• #39 Atrial Tachycardia: Diagnosis and Treatment – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/cardiology/atrial-tachycardia-diagnosis-and-treatment/

  The diagnosis of supraventricular tachycardias and specifically atrial tachycardias is established with the documentation and characterization of the heart rhythm as discussed in section II E 2 below. […] The definitive diagnosis confirmation of an atrial tachycardia is best done in the electrophysiology laboratory. Intracardiac recordings and response to pacing maneuvers during tachycardia, as well as characteristics of tachycardia induction and activation maps, provide a definitive diagnosis of the mechanism of the tachycardia as well as an opportunity for definitive treatment through ablation.

• #40 Atrial Tachycardia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/atrial-tachycardia

  If your doctor suspects that you may have an arrhythmia, he or she will order one or more of the following diagnostic tests to determine the source of your symptoms. […] The electrocardiogram (ECG or EKG) records the heart’s electrical activity. […] A holter monitor is a small, portable machine that you wear for 24 hours. […] The exercise stress (treadmill) test enables physicians to record your heart’s electrical activity which may not occur at rest. […] An event recorder (loop recorder) is a small portable transtelephonic monitor that may be worn for several weeks. […] Magnetic source imaging (MSI) is used as an overlay to magnetic resonance imaging (MRI). […] Tilt table testing is used to diagnose fainting or black-out spells (vasovagal syncope) by trying to reproduce the black-out episodes. […] The EP study allows doctors to acquire more accurate, detailed information and, in many cases, provide treatment (i.e. catheter ablation) during the same session.

• #41 Atrial Tachycardia

  https://www.washingtonhra.com/arrhythmias/atrial-tachycardia.php

  Atrial tachycardia can be diagnosed by your physician via an electrocardiogram or an ambulatory monitoring device, i.e. Holter or Event monitor, specifically during an arrhythmia episode. […] Your physician can use the 12-lead EKG performed in the office or hospital to help localize the site of origin based on the morphology of the p-wave (represents cardiac atrial activation). […] For patients who require an unequivocal diagnosis, or who are candidates for a curative catheter ablation procedure, an intracardiac electrophysiology study is the gold standard test to establish the diagnosis.

• #42 Atrial Tachycardia Workup: Approach Considerations, Exclusion of Systemic Disorders, Electrocardiography

  https://emedicine.medscape.com/article/151456-workup

  All patients who present acutely with possible atrial tachycardia should be placed on pulse oximetry and a cardiac monitor. A 12-lead electrocardiogram (ECG) and rhythm strip is an important tool to help identify, locate, and differentiate atrial tachycardia. […] The following laboratory studies may be indicated to exclude systemic disorders that could be causing the tachycardia: […] Echocardiography can be valuable. Invasive electrophysiologic study may be required. […] The advent of three-dimensional (3-D) high-density and rapid electroanatomic mapping to characterize atrial tachycardias appears to have the potential to result in favorable outcomes following ablation. […] At the beginning of the workup for atrial tachycardia, appropriate laboratory studies should be performed to exclude systemic causes of sinus tachycardia (eg, fever, hyperthyroidism, anemia, dehydration, infection, hypoxemia, metabolic disturbance).

• #43 Electrocardiogram Recognition and Ablation of Atrial Tachycardia | ECR Journal

  https://www.ecrjournal.com/articles/electrocardiogram-recognition-and-ablation-atrial-tachycardia?language_content_entity=en

  In general, mapping of focal AT requires sufficient density of focal activity in the case of an automatic focus or reliable inducibility with programmed stimulation. […] The most commonly used technique to locate AT focus is endocardial activation mapping. […] The introduction of 3-D mapping systems has greatly facilitated the mapping and ablation of focal AT. […] For the majority of focal ATs, RF is the energy source of choice. […] AT ablation series have reported success rates between 69% and 100% with low incidence of complications. […] Patients with focal PV AT have a high ablation success rate and the long-term incidence of progressing to AF is low. Different ablation strategies have included focal mapping and ablation or alternately single PV circumferential isolation.

• #44 Electrocardiogram Recognition and Ablation of Atrial Tachycardia | ECR Journal

  https://www.ecrjournal.com/articles/electrocardiogram-recognition-and-ablation-atrial-tachycardia?language_content_entity=en

  In general, mapping of focal AT requires sufficient density of focal activity in the case of an automatic focus or reliable inducibility with programmed stimulation. […] The most commonly used technique to locate AT focus is endocardial activation mapping. […] The introduction of 3-D mapping systems has greatly facilitated the mapping and ablation of focal AT. […] For the majority of focal ATs, RF is the energy source of choice. […] AT ablation series have reported success rates between 69% and 100% with low incidence of complications. […] Patients with focal PV AT have a high ablation success rate and the long-term incidence of progressing to AF is low. Different ablation strategies have included focal mapping and ablation or alternately single PV circumferential isolation.

• #45 Atrial Tachycardia | Thoracic Key

  https://thoracickey.com/atrial-tachycardia-3/

  These advanced mapping systems have been found to facilitate identification and ablation of ATs arising from the atrial chamber, the atrial septum, pulmonary veins, superior vena cava (SVC), or coronary sinus. […] The ability to collect a large number of points with high spatial resolution (1 to 2mm) enables the construction of a detailed activation map that is combined with the three-dimensional anatomy of the relevant chamber. […] Noninvasive electrocardiographic imaging or electrocardiographic mapping (ECM) is a promising tool for diagnosis of tachycardia origin and could be useful in procedure planning before catheter ablation.

• #46 Atrial Tachycardia | Thoracic Key

  https://thoracickey.com/atrial-tachycardia-3/

  Electrocardiographic P wave duration correlated with the duration of intraatrial activation. Focal ATs had shorter P wave durations and smaller ratios of P wave to cycle length. P waves less than 160ms and P wave to cycle length ratios less than 45% differentiated focal AT from macroreentry with promising accuracy in patients who subsequently underwent invasive catheter mapping and ablation. […] Extensive activation sequence mapping is typically used in the electrophysiology laboratory to define the presumptive mechanism of AT and plan an ablation strategy. Technologies for mapping arrhythmias include basket mapping, electroanatomic mapping, and noncontact mapping systems. […] The mapping technologies have definite advantages over point-by-point catheter mapping, including the ability to map unstable, poorly reproducible, and nonsustained arrhythmias.

• #47 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  The differential diagnosis of narrow-complex tachycardias, including the PSVTs, is important because treatment differs depending on the arrhythmia. This requires scrutiny of the ECG with close attention to P-wave and QRS shapes and to the PR and RR intervals. […] Prognosis depends on the underlying cause. Unifocal atrial tachycardia is usually benign in adults and may not require treatment if it is not sustained. On the other hand, incessant atrial tachycardia can contribute directly to tachycardic cardiomyopathy and reversible heart failure. […] Atrial tachycardia is a form of tachyarrhythmia, a heart rhythm in which the heart beats faster than 100 beats per minute due to an electrical signal in the atria. Atrial tachycardia is a type of paroxysmal supraventricular tachycardia (PSVT), a group of arrhythmias that originate above the atrioventricular junction (AVJ).

• #48 Atrial Tachycardia Differential Diagnoses

  https://emedicine.medscape.com/article/151456-differential

  The differential diagnosis of atrial tachycardia is the differential diagnosis of supraventricular tachycardia (SVT) and includes the following: […] Differentiating among these diagnoses requires electrocardiographic (ECG) analysis of the tachycardia for P wave activity. […] Diagnosis requires assessment of the patient condition, vagal maneuvers, adenosine, and cardioversionnamely, procedures that may not only be diagnostic but also therapeutic. […] However, if the patient also has new signs or symptoms (eg, chest pain, unexplained dyspnea, inappropriate hypotension) or a recent illness, perform a more extensive workup because atrial tachycardia may not be the primary problem; acute pulmonary embolus, acute noncardiac illness, thyroid disease, or drugs (especially sympathomimetics or bronchodilators) can cause atrial tachycardia. […] Another tachycardia that mimics atrial tachycardia is inappropriate sinus tachycardia.

• #49 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #50 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #51 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #52 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #53 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Abrupt onset of tachycardia is indicative of atrial tachycardia while gradual onset is suggestive of sinus tachycardia. In unifocal tachycardia, the P-waves outnumber the QRS complexes, which helps to differentiate atrial tachycardia from sinus tachycardia. […] The prognosis of MAT will relate in large part to underlying lung disease. Treatment for paroxysmal supraventricular tachycardia includes a variety of antiarrhythmic drugs and/or catheter ablation of the abnormal focus or foci. Unifocal atrial tachycardia may respond to medication; ablation with 3-dimensional mapping technology is frequently successful. […] Atrial tachycardia and the other PSVTs may be misdiagnosed as panic disorder or anxiety disorder, which may be hazardous if an incessant arrhythmia is overlooked.

• #54 Common Types of Supraventricular Tachycardia: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1015/p942.html

  The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing accelerated heart rates. […] Diagnosis is often delayed because of the misdiagnosis of anxiety or panic disorder. Patient history is important in uncovering the diagnosis, whereas the physical examination may or may not be helpful. A Holter monitor or an event recorder is usually needed to capture the arrhythmia and confirm a diagnosis. […] Atrial tachycardia (AT) is the third most common type of SVT (approximately 10 percent); it originates from a single atrial focus. […] The history may reveal the likely etiology underlying the SVT. Sinus tachycardia must be considered in the differential diagnosis. […] A 12-lead ECG should be performed in patients who are hemodynamically stable, with special attention to rhythm and rate, atrioventricular conduction (PR interval), RP interval, hypertrophy, pathologic Q waves, prolongation of the QT interval, and any evidence of preexcitation.

• #55 Focal atrial tachycardia – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/182

  Focal atrial tachycardia occurs in the settings of structurally normal heart, coronary artery disease, congestive heart failure, cardiac surgery, catecholamine ingestion, digoxin toxicity, and alcohol dependency. […] ECG shows a regular atrial tachycardia with P-wave morphology different from that in sinus tachycardia. […] The diagnosis of focal AT is usually based on ECG, clinical history, and response to interventions such as vagal maneuvers and adenosine. […] 1st tests to order include ECG, digoxin level, theophylline level, CXR, electrolytes, and toxicology screen. […] Tests to consider include vagal maneuvers, adenosine, thyroid-stimulating hormone, echocardiogram, ambulatory 24-hour (Holter) ECG or event recorder, and electrophysiologic study (EPS).

• #56 Atrial Tachycardia Diagnosis & Treatment in Birmingham | Rapid Heartbeat

  https://www.stop-af.com/about-your-rhythm/atrial-tachycardia/

  Atrial tachycardia (AT) is a type of heart arrhythmia that causes your heart to beat 100 to 300 times each minute. […] Dr. Smith can diagnose atrial tachycardia in his office with an electrocardiogram (ECG/EKG), but when the elevated heart rates are only occasional occurrences, the ECG may show normal results. […] In these cases, Dr. Smith will have you wear an ECG monitor at home. This will record your heart rhythm over time. […] Blood tests can be used to check thyroid function, heart disease, and other conditions that can trigger atrial tachycardia. […] Stress tests done on a treadmill or stationary bike can also be used to monitor heart activity.

• #57 Atrial Tachycardia Workup: Approach Considerations, Exclusion of Systemic Disorders, Electrocardiography

  https://emedicine.medscape.com/article/151456-workup

  Chest radiography is indicated to evaluate for a pulmonary etiology (eg, chronic obstructive pulmonary disease) and to delineate cardiac size and structures and cardiac findings in patients who present with tachycardia-induced cardiomyopathy and in those with complex congenital heart disease. […] Ideally, a full 12-lead electrocardiogram (ECG) and rhythm strip and with a clear baseline is obtained to allow the most accurate evaluation of P wave morphology. […] The P wave morphology in leads aVL and V1 are most helpful for distinguishing the location of the arrhythmic focus (ie, right versus left atrium). […] In most cases, the PR interval is shorter than the RP interval. […] The diagnosis of multifocal atrial tachycardia (MAT) is confirmed with an electrocardiogram (ECG) that meets the following criteria:

• #58 Atrial tachycardia: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/atrial-tachycardia

  Atrial tachycardia is an arrhythmia with a heart rate greater than 100 beats per minute that originates in the atria, or upper chambers, of the heart. […] A doctor can diagnose atrial tachycardia by monitoring the heart rate and electrical signals in the heart. This usually begins with an electrocardiogram (ECG), which measures electrical patterns in the heart. […] Sometimes, an ECG may indicate a typical heart rate because the heart is not currently in an arrhythmia. Longer-term monitoring may help detect an arrhythmia. […] A healthcare professional may also order other diagnostic tests to determine the underlying cause of atrial tachycardia. These may include: echocardiogram, stress testing, heart catheterization. […] Anyone who experiences symptoms of atrial tachycardia should speak with a healthcare professional. A doctor can conduct diagnostic tests and recommend appropriate treatment if necessary.

• #59 Atrial Tachycardia Workup: Approach Considerations, Exclusion of Systemic Disorders, Electrocardiography

  https://emedicine.medscape.com/article/151456-workup

  Echocardiography is an important diagnostic modality. It is used to assess structural heart disease and to evaluate the following: […] An electrophysiology study may be required to establish the diagnosis of atrial tachycardia, usually by excluding other tachycardia mechanisms (e, atrioventricular [AV] reentrant tachycardia [AVNRT]). […] Event monitoring or home telemetry may provide useful information, especially in patients with paroxysmal symptoms. These procedures can be helpful for the following aspects of diagnosis:

• #60 Tachycardia: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/what-are-the-types-of-tachycardia

  Tachycardia Diagnosis […] To find out whether you have tachycardia, your doctor may order different kinds of tests. They include: […] Electrocardiogram (EKG). This records the electrical activity in your heart and helps your doctor search for things that don’t look normal. You may have to wear a Holter monitor, a portable machine that records your EKG signals over 24 hours. […] Event monitor. This is like a Holter monitor, but it records only a few minutes at a time several times a day. You might need to wear it for 30 days. When you feel symptoms, you might push a button to start the measurement. Or the device may detect changes in your heart rhythm and record automatically. […] Exercise stress test. Your doctor will have you walk on a treadmill while they monitor your heart activity.

• #61 Atrial Tachycardia | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/atrial-tachycardia

  An exercise stress or treadmill test records the electrical activity of your child’s heart during exercise, which differs from the heart’s electrical activity at rest. […] This is a small monitor about the size of a pager that your child can have for up to a month. Since the arrhythmia may occur at unpredictable times, this will help to record the abnormal rhythm when your child is experiencing symptoms. […] A Holter monitor is a small, portable machine that your child wears for 24 hours. It is about the size of a portable tape player and provides a continuous 24-hour recording of your child’s heartbeat onto a tape. You will be asked to keep a diary of your child’s activities and symptoms. This monitor may detect arrhythmias that might not show up on a resting electrocardiogram, which only records a heartbeat for a few seconds at rest.

• #62 Common Types of Supraventricular Tachycardia: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1015/p942.html

  Patients should be expediently referred to a cardiologist or electrophysiologist if they have experienced syncope or severe dyspnea, or if preexcitation is present on resting 12-lead ECG. […] The primary treatment goal for any SVT is its cessation, especially in patients who are at risk hemodynamically and cannot tolerate prolonged tachyarrhythmias. […] Adenosine is an atrioventricular nodal blocking agent with a very short half-life (nine to 12 seconds). It is highly effective for the termination of nodal-dependent SVT and is the first-line drug for acute conversion of narrow complex SVT. […] Because AT is an atrioventricular nodal-independent SVT, atrioventricular nodal blocking agents, such as verapamil or adenosine, are mostly ineffective in its termination.

• #63 Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P‐Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6931826/

  In order to correctly differentiate an AT from other NCTs, we propose a simple diagnostic algorithm with a step-by-step approach. […] Holter analysis could offer further details to discriminate between AT and another SVT. […] Whenever there is an SVT without visible P waves and without undulating pattern, it may be: 1:1 or 2:1 AT, common AVNRT, orthodromic AVRT, or JT. […] If the diagnosis is uncertain, it is possible to utilize vagal maneuvers, such as sinus carotid massage, or adenosine administration. […] A good knowledge and interpretation of the ECG could help the physician to differentiate focal and macroreentrant AT from the other SVTs and to manage and to treat correctly these patients.

• #64 Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P‐Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6931826/

  In order to correctly differentiate an AT from other NCTs, we propose a simple diagnostic algorithm with a step-by-step approach. […] Holter analysis could offer further details to discriminate between AT and another SVT. […] Whenever there is an SVT without visible P waves and without undulating pattern, it may be: 1:1 or 2:1 AT, common AVNRT, orthodromic AVRT, or JT. […] If the diagnosis is uncertain, it is possible to utilize vagal maneuvers, such as sinus carotid massage, or adenosine administration. […] A good knowledge and interpretation of the ECG could help the physician to differentiate focal and macroreentrant AT from the other SVTs and to manage and to treat correctly these patients.

• #65 Atrial Tachycardia – Cardio Guide

  https://www.cardioguide.ca/atrial-tachycardia/

  Diagnosis […] Definition: Atrial rhythm 100bpm initiated from a discrete origin. Ventricular rate varies depending on AV nodal conduction. Can be paroxysmal, sustained, or incessant. […] ECG Features: The key is to find the P-waves! Depending on velocity of AV conduction, P-waves can be located anywhere in the cycle (commonly in the QRS or T-wave). P-waves often have different morphology to sinus P-waves (compare to sinus ECG). Caveat: P-wave morphology can match sinus P-waves when the focus is close to the sinus node. P-wave morphology can resemble retro-conducted P-waves if the origin is low in the atrium or close to the AV node. […] Sometimes a Warm-Up and Cool-Off phenomenon can be seen where the tachycardia accelerates and gradually slows down before terminating. […] SVT that terminates on a P-wave is significantly less likely to be AT. Explanation: If a tachycardia terminates on a P-wave, the atrial focus must stop firing, and the AV node must block on the same beat. Both of these events are statistically unlikely to happen on the same beat.

• #66 Focal atrial tachycardia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/182

  Focal atrial tachycardia occurs in the settings of structurally normal heart, coronary artery disease, congestive heart failure, cardiac surgery, catecholamine ingestion, digoxin toxicity, and alcohol dependency. […] Symptoms and signs include palpitations, fatigue, pre-syncope/syncope, chest pain, and dyspnoea. […] ECG shows a regular atrial tachycardia with P-wave morphology different from that in sinus tachycardia. […] A trial of adenosine can help differentiate focal AT from other supraventricular tachycardias. […] The diagnosis of focal AT is usually based on ECG, clinical history, and response to interventions such as vagal manoeuvres and adenosine. […] Key diagnostic factors include presence of risk factors and cardiac disease. […] 1st investigations to order include ECG, digoxin level, theophylline level, CXR, electrolytes, and toxicology screen. […] Investigations to consider include vagal manoeuvres, adenosine, thyroid-stimulating hormones, echocardiogram, ambulatory 24-hour (Holter) ECG or event recorder, and electrophysiological study (EPS).

• #67 Atrial Tachycardia | Thoracic Key

  https://thoracickey.com/atrial-tachycardia-3/

  Electrocardiographic P wave duration correlated with the duration of intraatrial activation. Focal ATs had shorter P wave durations and smaller ratios of P wave to cycle length. P waves less than 160ms and P wave to cycle length ratios less than 45% differentiated focal AT from macroreentry with promising accuracy in patients who subsequently underwent invasive catheter mapping and ablation. […] Extensive activation sequence mapping is typically used in the electrophysiology laboratory to define the presumptive mechanism of AT and plan an ablation strategy. Technologies for mapping arrhythmias include basket mapping, electroanatomic mapping, and noncontact mapping systems. […] The mapping technologies have definite advantages over point-by-point catheter mapping, including the ability to map unstable, poorly reproducible, and nonsustained arrhythmias.

• #68 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Atrial tachycardia (AT) is a heart rhythm disorder that originates in the atria, defined as a supraventricular tachycardia that does not require the participation of the atrioventricular junction, accessory pathways, or ventricular tissue for its onset or maintenance. […] The ECG typically shows a tachycardia at a narrow QRS (unless there is a conduction aberrance or a bundle branch block). […] The morphology of the P wave observed on the surface ECG could give indications regarding the site of onset and the mechanism of atrial tachycardia. […] The criteria that have been proposed for the diagnosis of automatic atrial tachycardia are the following: 1) Spontaneous onset without correlation with critical frequencies or coupling intervals; 2) Constant endocardial activation pattern from the first beat; 3) Inability to induce or end tachycardia with atrial or ventricular stimulation; 4) Demonstration of the warm-up phase at the beginning of tachycardia; 5) Ability to reset tachycardia with earlier atrial extrasystoles; 6) Suppression of tachycardia with rapid atrial pacing manoeuvres; 7) P-R is related to the frequency of tachycardia; 8) P waves differ from sinus (for differential diagnosis with inappropriate sinus tachycardia).

• #69 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  The criteria used for the diagnosis of atrial tachycardia from triggered activity are as follows: 1) it can be induced through programmed atrial stimulation and atrial pacing and is independent of the atrial conduction delay and the atrioventricular conduction delay; 2) Atrial pacing, cycle length and the coupling interval of atrial extrasystoles are directly related to the interval of onset of atrial tachycardia and to the initial length of the tachycardia cycle; 3) P-R is related to the frequency of tachycardia; 4) The degree of blockage of the tachycardia does not affect the cycle of the same; 5) acceleration of tachycardia during overdrive is also a typical electrophysiological finding. […] The most common form of macroreentry atrial tachycardia, with the advent of circumferential ablation of the pulmonary veins, is left atrial tachycardia, depending on the gaps that can occur in the lesions.

• #70 Atrial tachycardias – AF-ABLATION

  https://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/

  Diagnostic criteria for multifocal atrial tachycardia include: 1) an irregular atrial rate greater than 100 bpm; 2) at least 3 different P wave morphologies without, however, evidence of a dominant pacemaker; 3) irregular PP interval; 4) presence of the isoelectric line between the P waves. […] Differential diagnosis of atrial tachycardia is made with the following: sinus tachycardia, atrial flutter, atrial fibrillation, AVRT, NRT. […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #71 Electrocardiogram Recognition and Ablation of Atrial Tachycardia | ECR Journal

  https://www.ecrjournal.com/articles/electrocardiogram-recognition-and-ablation-atrial-tachycardia?language_content_entity=en

  Focal atrial tachycardia (AT) is a relatively uncommon cause of supraventricular tachycardia, but when present is frequently difficult to treat medically. […] The P-wave morphology on surface electrocardiogram (ECG) together with more sophisticated contemporary mapping techniques facilitates precise localisation and ablation of these ectopic foci. Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients. […] Electrocardiographic P-wave morphology can provide a useful indication of the likely site of focal AT origin, which are generally distributed to characteristic anatomical locations. […] This article will discuss localisation of atrial tachycardia using P-wave morphology and techniques of endocardial mapping to facilitate successful ablation.

• #72 Electrocardiogram Recognition and Ablation of Atrial Tachycardia | ECR Journal

  https://www.ecrjournal.com/articles/electrocardiogram-recognition-and-ablation-atrial-tachycardia?language_content_entity=en

  Focal atrial tachycardia (AT) is a relatively uncommon cause of supraventricular tachycardia, but when present is frequently difficult to treat medically. […] The P-wave morphology on surface electrocardiogram (ECG) together with more sophisticated contemporary mapping techniques facilitates precise localisation and ablation of these ectopic foci. Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients. […] Electrocardiographic P-wave morphology can provide a useful indication of the likely site of focal AT origin, which are generally distributed to characteristic anatomical locations. […] This article will discuss localisation of atrial tachycardia using P-wave morphology and techniques of endocardial mapping to facilitate successful ablation.

• #73 Atrial Tachycardia – Cardio Guide

  https://www.cardioguide.ca/atrial-tachycardia/

  Response To Adenosine: Adenosine blocks the AV node, which stops ventricular activation, revealing AT P-waves. Compare these P-waves to the sinus ECG. Usually P-waves are discrete and separated by an isoeletric period. Tachycardia continues after adenosine effect wears off. NOTE: Some atrial tachycardias are adenosine-sensitive, and can slow down or terminate with adenosine. […] Localizing Atrial Origin (Advanced): Negative P wave in lead I and aVL suggests LA origin. V1 is negative lateral RA. V1 is biphasic or positive Septal RA and LA. Negative in inferior leads Inferior origin. Positive in inferior leads Superior origin. […] Acute Therapy: If unstable Cardioversion (Class IA). Identify and treat associated conditions: LA stretch (HF, CMP, HTN), MI, PE, infection, alcohol, electrolytes, cocaine/stimulants, theophyline. Adenosine (IIA) rarely work. Adenosine can convert DAD-triggered AT. B-Blockers (IIA) can terminate or slow the rate. Avoid in decompensated HF. Metoprolol 2.5-5mg IV over 2-5min (max 15mg). CCB (IIA) avoid in Hypotension and HFrEF. Diltiazem 20mg IV bolus over 2min, repeat q15min. Verapamil: 5-10mg IV over 2min. Additional 10mg IV can be given after 15-30min.

• #74 Atrial Tachycardia

  https://www.washingtonhra.com/arrhythmias/atrial-tachycardia.php

  Atrial tachycardia can be diagnosed by your physician via an electrocardiogram or an ambulatory monitoring device, i.e. Holter or Event monitor, specifically during an arrhythmia episode. […] Your physician can use the 12-lead EKG performed in the office or hospital to help localize the site of origin based on the morphology of the p-wave (represents cardiac atrial activation). […] For patients who require an unequivocal diagnosis, or who are candidates for a curative catheter ablation procedure, an intracardiac electrophysiology study is the gold standard test to establish the diagnosis.

• #75 Multifocal Atrial Tachycardia (MAT)

  https://my.clevelandclinic.org/health/diseases/24009-multifocal-atrial-tachycardia

  Multifocal atrial tachycardia is a rare type of abnormal heart rhythm that usually affects people with lung disease. […] Healthcare providers usually discover multifocal atrial tachycardia on an electrocardiogram (EKG) reading. […] An electrocardiogram (EKG) is the only test a provider needs to make a MAT diagnosis. […] Many people with multifocal atrial tachycardia only need treatment for the condition that caused it. MAT usually goes away once you get treatment for the cause. […] Your prognosis depends on the condition that caused your multifocal atrial tachycardia.

• #76 Multifocal Atrial Tachycardia (MAT) • LITFL • ECG Library Diagnosis

  https://litfl.com/multifocal-atrial-tachycardia-mat-ecg-library/

  A rapid, irregular atrial rhythm arising from multiple ectopic foci within the atria. […] Most commonly seen in patients with severe COPD or congestive heart failure. […] It is typically a transitional rhythm between frequent premature atrial complexes (PACs) and atrial flutter / fibrillation. […] At least 3 distinct P-wave morphologies in the same lead. […] Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent PACs). […] Usually occurs in seriously ill elderly patients with respiratory failure (e.g. exacerbation of COPD / CHF). […] Tends to resolve following treatment of the underlying disorder. […] The development of MAT during an acute illness is a poor prognostic sign, associated with a 60% in-hospital mortality and mean survival of just over a year. Death occurs due to the underlying illness; not the arrhythmia itself. […] The net result is increased atrial automaticity.

• #77 Multifocal Atrial Tachycardia (MAT)

  https://my.clevelandclinic.org/health/diseases/24009-multifocal-atrial-tachycardia

  Multifocal atrial tachycardia is a rare type of abnormal heart rhythm that usually affects people with lung disease. […] Healthcare providers usually discover multifocal atrial tachycardia on an electrocardiogram (EKG) reading. […] An electrocardiogram (EKG) is the only test a provider needs to make a MAT diagnosis. […] Many people with multifocal atrial tachycardia only need treatment for the condition that caused it. MAT usually goes away once you get treatment for the cause. […] Your prognosis depends on the condition that caused your multifocal atrial tachycardia.

• #78 Orphanet: Multifocal atrial tachycardia

  https://www.orpha.net/en/disease/detail/3282

  Multifocal atrial tachycardia is a rare supraventricular arrhythmia in neonates and young infants that is characterized by multiple P waves with varying P wave morphology and is usually asymptomatic. […] Diagnosis is made by surface electrocardiogram: atrial activity is polymorphic (at least 3 different morphologies of P waves with a discrete isoelectric baseline, and variable PP, RR, and PR intervals), rapid (atrial rates can increase up to 400 beats per minute), and irregular. Atrioventricular conduction is variable so that some P waves are not conducted. Rate-related QRS widening (aberrancy) is sometimes seen. […] Differential diagnosis includes most other types of tachycardia (e.g. nonsustained ventricular tachycardia, paroxysmal supraventricular tachycardia (PSVT)).

• #79 Multifocal Atrial Tachycardia: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/multifocal-atrial-tachycardia

  Sometimes people with MAT have these signs: […] But many times, people with MAT dont feel like their heart isnt beating normally or notice other signs. Doctors often find it unexpectedly in people with other health problems. […] Its hard to tell from a physical exam if a person has MAT. But this irregular heart rhythm will show up in an electrocardiogram (EKG). This test records electrical signals in the heart. If a doctor finds MAT on an EKG, your pulse also may be fast and irregular. Without an EKG, itd be hard to tell the difference between MAT and some other type of arrhythmia.

• #80 Multifocal Atrial Tachycardia: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/multifocal-atrial-tachycardia

  Sometimes people with MAT have these signs: […] But many times, people with MAT dont feel like their heart isnt beating normally or notice other signs. Doctors often find it unexpectedly in people with other health problems. […] Its hard to tell from a physical exam if a person has MAT. But this irregular heart rhythm will show up in an electrocardiogram (EKG). This test records electrical signals in the heart. If a doctor finds MAT on an EKG, your pulse also may be fast and irregular. Without an EKG, itd be hard to tell the difference between MAT and some other type of arrhythmia.

• #81 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Drugs that can cause atrial tachycardia include digoxin and theophylline. Other medications include -adrenergic agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also precipitate an atrial arrhythmia. […] Unifocal type, otherwise known as focal atrial tachycardia occurs as a result of either automaticity of an atrial ectopic site or reentry. The ECG is that of sinus tachycardia, with a P wave before each QRS complex. But the morphology of the P-wave is different from that of sinus rhythm, demonstrating depolarization of the atrium from an atypical location. […] In multifocal atrial tachycardia (MAT), the ECG shows an irregular rhythm with at least 3 different P-wave morphologies, and the average atrial rate is 100 beats/min. This rhythm most often occurs in the setting of severe pulmonary disease or hypomagnesemia.

• #82 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Drugs that can cause atrial tachycardia include digoxin and theophylline. Other medications include -adrenergic agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also precipitate an atrial arrhythmia. […] Unifocal type, otherwise known as focal atrial tachycardia occurs as a result of either automaticity of an atrial ectopic site or reentry. The ECG is that of sinus tachycardia, with a P wave before each QRS complex. But the morphology of the P-wave is different from that of sinus rhythm, demonstrating depolarization of the atrium from an atypical location. […] In multifocal atrial tachycardia (MAT), the ECG shows an irregular rhythm with at least 3 different P-wave morphologies, and the average atrial rate is 100 beats/min. This rhythm most often occurs in the setting of severe pulmonary disease or hypomagnesemia.

• #83 Atrial Tachycardia Differential Diagnoses

  https://emedicine.medscape.com/article/151456-differential

  The differential diagnosis of atrial tachycardia is the differential diagnosis of supraventricular tachycardia (SVT) and includes the following: […] Differentiating among these diagnoses requires electrocardiographic (ECG) analysis of the tachycardia for P wave activity. […] Diagnosis requires assessment of the patient condition, vagal maneuvers, adenosine, and cardioversionnamely, procedures that may not only be diagnostic but also therapeutic. […] However, if the patient also has new signs or symptoms (eg, chest pain, unexplained dyspnea, inappropriate hypotension) or a recent illness, perform a more extensive workup because atrial tachycardia may not be the primary problem; acute pulmonary embolus, acute noncardiac illness, thyroid disease, or drugs (especially sympathomimetics or bronchodilators) can cause atrial tachycardia. […] Another tachycardia that mimics atrial tachycardia is inappropriate sinus tachycardia.

• #84 Atrial Tachycardia Differential Diagnoses

  https://emedicine.medscape.com/article/151456-differential

  The differential diagnosis of atrial tachycardia is the differential diagnosis of supraventricular tachycardia (SVT) and includes the following: […] Differentiating among these diagnoses requires electrocardiographic (ECG) analysis of the tachycardia for P wave activity. […] Diagnosis requires assessment of the patient condition, vagal maneuvers, adenosine, and cardioversionnamely, procedures that may not only be diagnostic but also therapeutic. […] However, if the patient also has new signs or symptoms (eg, chest pain, unexplained dyspnea, inappropriate hypotension) or a recent illness, perform a more extensive workup because atrial tachycardia may not be the primary problem; acute pulmonary embolus, acute noncardiac illness, thyroid disease, or drugs (especially sympathomimetics or bronchodilators) can cause atrial tachycardia. […] Another tachycardia that mimics atrial tachycardia is inappropriate sinus tachycardia.

• #85 Atrial Tachycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542235/

  A focal atrial tachycardia is an arrhythmia with electrical impulses originating and confined within the atria. […] Appropriate diagnosis of focal atrial tachycardia must be made to guide proper management. […] Atrial tachycardia is an arrhythmia with electrical impulses originating within the atria. […] EKG can aid the diagnosis of focal atrial tachycardia. […] Initial management of focal atrial tachycardia should focus on addressing underlying causes: treating acute illness, cessation of stimulants, stress reduction, appropriately managing digoxin toxicity, or chronic disease management. […] Diagnosis of atrial arrhythmias is reliant on detection. […] Proper management of atrial tachycardia requires an interprofessional team approach, including physicians, specialists, specialty-trained nurses, and pharmacists, all collaborating across disciplines to achieve optimal patient results.

• #86 Telemetry Tips Part 1: Atrial Flutter and Atrial Tachycardia – Temple Health

  https://physicianresources.templehealth.org/videos/telemetry-tips-part-1-atrial-flutter-and-atrial-tachycardia

  Atrial flutter atrial tachycardia with 2:1 and 1:1 AV conduction is mistakenly called „sinus tachycardia” and is often missed. […] In my experience, this is one of the biggest missed diagnoses. […] You miss the opportunity to anticoagulate somebody and reduce their risk of stroke and also slow the rate and control the rhythm and avoid tachycardiac cardiomyopathy and other symptoms that go along with a missed diagnosis of ongoing tachycardia. […] The diagnosis is pretty simple. […] One thing that people sometimes don’t appreciate is that when you have a flutter wave or a P wave that falls on a QR S T wave complex, that P wave may go may be somewhat invisible because it’s obscured, not a big deal if you have more P waves than QR S is because you see all of the rest and make the die diagnosis.

• #87 Telemetry Tips Part 1: Atrial Flutter and Atrial Tachycardia – Temple Health

  https://physicianresources.templehealth.org/videos/telemetry-tips-part-1-atrial-flutter-and-atrial-tachycardia

  Atrial flutter atrial tachycardia with 2:1 and 1:1 AV conduction is mistakenly called „sinus tachycardia” and is often missed. […] In my experience, this is one of the biggest missed diagnoses. […] You miss the opportunity to anticoagulate somebody and reduce their risk of stroke and also slow the rate and control the rhythm and avoid tachycardiac cardiomyopathy and other symptoms that go along with a missed diagnosis of ongoing tachycardia. […] The diagnosis is pretty simple. […] One thing that people sometimes don’t appreciate is that when you have a flutter wave or a P wave that falls on a QR S T wave complex, that P wave may go may be somewhat invisible because it’s obscured, not a big deal if you have more P waves than QR S is because you see all of the rest and make the die diagnosis.

• #88 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  The differential diagnosis of narrow-complex tachycardias, including the PSVTs, is important because treatment differs depending on the arrhythmia. This requires scrutiny of the ECG with close attention to P-wave and QRS shapes and to the PR and RR intervals. […] Prognosis depends on the underlying cause. Unifocal atrial tachycardia is usually benign in adults and may not require treatment if it is not sustained. On the other hand, incessant atrial tachycardia can contribute directly to tachycardic cardiomyopathy and reversible heart failure. […] Atrial tachycardia is a form of tachyarrhythmia, a heart rhythm in which the heart beats faster than 100 beats per minute due to an electrical signal in the atria. Atrial tachycardia is a type of paroxysmal supraventricular tachycardia (PSVT), a group of arrhythmias that originate above the atrioventricular junction (AVJ).

• #89 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Abrupt onset of tachycardia is indicative of atrial tachycardia while gradual onset is suggestive of sinus tachycardia. In unifocal tachycardia, the P-waves outnumber the QRS complexes, which helps to differentiate atrial tachycardia from sinus tachycardia. […] The prognosis of MAT will relate in large part to underlying lung disease. Treatment for paroxysmal supraventricular tachycardia includes a variety of antiarrhythmic drugs and/or catheter ablation of the abnormal focus or foci. Unifocal atrial tachycardia may respond to medication; ablation with 3-dimensional mapping technology is frequently successful. […] Atrial tachycardia and the other PSVTs may be misdiagnosed as panic disorder or anxiety disorder, which may be hazardous if an incessant arrhythmia is overlooked.

• #90 Atrial Tachycardia: Diagnosis – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/atrial-tachycardia-diagnosis/

  Abrupt onset of tachycardia is indicative of atrial tachycardia while gradual onset is suggestive of sinus tachycardia. In unifocal tachycardia, the P-waves outnumber the QRS complexes, which helps to differentiate atrial tachycardia from sinus tachycardia. […] The prognosis of MAT will relate in large part to underlying lung disease. Treatment for paroxysmal supraventricular tachycardia includes a variety of antiarrhythmic drugs and/or catheter ablation of the abnormal focus or foci. Unifocal atrial tachycardia may respond to medication; ablation with 3-dimensional mapping technology is frequently successful. […] Atrial tachycardia and the other PSVTs may be misdiagnosed as panic disorder or anxiety disorder, which may be hazardous if an incessant arrhythmia is overlooked.

• #91 Atrial Tachycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542235/

  A focal atrial tachycardia is an arrhythmia with electrical impulses originating and confined within the atria. […] Appropriate diagnosis of focal atrial tachycardia must be made to guide proper management. […] Atrial tachycardia is an arrhythmia with electrical impulses originating within the atria. […] EKG can aid the diagnosis of focal atrial tachycardia. […] Initial management of focal atrial tachycardia should focus on addressing underlying causes: treating acute illness, cessation of stimulants, stress reduction, appropriately managing digoxin toxicity, or chronic disease management. […] Diagnosis of atrial arrhythmias is reliant on detection. […] Proper management of atrial tachycardia requires an interprofessional team approach, including physicians, specialists, specialty-trained nurses, and pharmacists, all collaborating across disciplines to achieve optimal patient results.

• #92 Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P‐Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6931826/

  Atrial tachycardia is defined as a regular atrial activation from atrial areas with centrifugal spread, caused by enhanced automaticity, triggered activity or microreentry. […] Atrial tachycardia should be differentiated from other supraventricular tachycardias. […] We propose a diagnostic algorithm in order to help the physician to discriminate among those. […] Holter analysis could offer further details to differentiate between atrial tachycardia and another supraventricular tachycardia. […] In conclusion, in spite of well-known limits, a good interpretation of ECG is very important and it could help the physician to manage and to treat correctly patients with atrial tachycardia. […] Moreover, localization of AT and differential diagnosis between AT and other supraventricular tachycardia (SVT) may be very hard and therefore the good knowledge of ECG is fundamental to diagnose and to treat correctly these rhythm disorders.

• #93 Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P‐Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6931826/

  Atrial tachycardia is defined as a regular atrial activation from atrial areas with centrifugal spread, caused by enhanced automaticity, triggered activity or microreentry. […] Atrial tachycardia should be differentiated from other supraventricular tachycardias. […] We propose a diagnostic algorithm in order to help the physician to discriminate among those. […] Holter analysis could offer further details to differentiate between atrial tachycardia and another supraventricular tachycardia. […] In conclusion, in spite of well-known limits, a good interpretation of ECG is very important and it could help the physician to manage and to treat correctly patients with atrial tachycardia. […] Moreover, localization of AT and differential diagnosis between AT and other supraventricular tachycardia (SVT) may be very hard and therefore the good knowledge of ECG is fundamental to diagnose and to treat correctly these rhythm disorders.

• #94 Atrial Tachycardia: Mechanisms, Diagnosis, and Interventional App

  https://www.longdom.org/open-access/atrial-tachycardia-mechanisms-diagnosis-and-interventional-approaches-1100179.html

  Atrial Tachycardia (AT), a supraventricular arrhythmia originating from the atria, represents a common yet often underappreciated cardiac rhythm disorder. […] The diagnosis of atrial tachycardia involves a combination of clinical assessment, Electrocardiographic (ECG) findings, and, in some cases, electrophysiological studies. […] In cases of persistent or symptomatic AT, Electrophysiological Studies (EPS) are invaluable for mapping the arrhythmia’s origin. […] AT is a complex arrhythmia with diverse mechanisms, ranging from ectopic foci to reentrant circuits. Its diagnosis requires a combination of clinical evaluation, electrocardiographic findings, and sometimes electrophysiological mapping.

• #95 Atrial tachycardia: Symptoms, causes, treatment, and more

  https://www.medicalnewstoday.com/articles/atrial-tachycardia

  Atrial tachycardia is an arrhythmia with a heart rate greater than 100 beats per minute that originates in the atria, or upper chambers, of the heart. […] A doctor can diagnose atrial tachycardia by monitoring the heart rate and electrical signals in the heart. This usually begins with an electrocardiogram (ECG), which measures electrical patterns in the heart. […] Sometimes, an ECG may indicate a typical heart rate because the heart is not currently in an arrhythmia. Longer-term monitoring may help detect an arrhythmia. […] A healthcare professional may also order other diagnostic tests to determine the underlying cause of atrial tachycardia. These may include: echocardiogram, stress testing, heart catheterization. […] Anyone who experiences symptoms of atrial tachycardia should speak with a healthcare professional. A doctor can conduct diagnostic tests and recommend appropriate treatment if necessary.

Zobacz więcej