Tachykardia przedsionkowa
Etiologia i przyczyny
Tachykardia przedsionkowa (AT) to arytmia nadkomorowa charakteryzująca się rytmem serca powyżej 100 uderzeń na minutę, wynikająca z nieprawidłowej aktywności elektrycznej w przedsionkach. Mechanizmy patofizjologiczne obejmują zwiększony automatyzm, aktywność wyzwalaną (często związaną z zaburzeniami kanałów wapniowych) oraz pobudzenie nawrotne (re-entry). AT występuje zarówno u pacjentów ze strukturalnymi chorobami serca (np. choroba niedokrwienna, kardiomiopatie, wady wrodzone, blizny po operacjach kardiochirurgicznych, choroby zastawkowe), jak i u osób ze zdrowym sercem. Szczególnie istotne są tachykardie po zabiegach kardiochirurgicznych (np. procedura Fontana) oraz po ablacji migotania przedsionków, gdzie szczeliny ablacyjne mogą stanowić podłoże arytmii. Czynniki niezwiązane bezpośrednio z chorobą strukturalną, takie jak zaburzenia elektrolitowe (hipokaliemia, hipomagnezemia), nadczynność tarczycy, hipoksja, nadmierna aktywacja układu współczulnego oraz toksyczność digoksyny, również odgrywają kluczową rolę w patogenezie AT.
- Etiologia tachykardii przedsionkowej
- Mechanizmy patofizjologiczne
- Strukturalne przyczyny tachykardii przedsionkowej
- Pozastrukturalne przyczyny tachykardii przedsionkowej
- Wieloogniskowa tachykardia przedsionkowa
- Czynniki ryzyka tachykardii przedsionkowej
- Szczególne rodzaje tachykardii przedsionkowej
- Jatrogeniczne przyczyny tachykardii przedsionkowej
- Konsekwencje tachykardii przedsionkowej
- Podsumowanie etiologii tachykardii przedsionkowej
Etiologia tachykardii przedsionkowej
Tachykardia przedsionkowa (AT) jest rodzajem arytmii nadkomorowej, która charakteryzuje się przyspieszonym rytmem serca pochodzącym z przedsionków, gdzie częstość akcji serca przekracza 100 uderzeń na minutę. Arytmia ta powstaje, gdy wadliwe sygnały elektryczne w przedsionkach zaburzają normalny rytm serca kontrolowany przez węzeł zatokowo-przedsionkowy. Stanowi około 5-15% wszystkich tachykardii nadkomorowych.12
Mechanizmy patofizjologiczne
Tachykardia przedsionkowa może wynikać z trzech głównych mechanizmów patofizjologicznych:12
- Zwiększony automatyzm – występuje, gdy ognisko ektopowe w przedsionku generuje impulsy elektryczne szybciej niż węzeł zatokowo-przedsionkowy
- Aktywność wyzwalana – zwykle związana z późnymi depolaryzacjami następującymi po potencjale czynnościowym, często związana z zaburzeniami kanałów wapniowych
- Pobudzenie nawrotne (re-entry) – może obejmować mikro- lub makro-obwody nawrotne w przedsionkach
Często ogniskowa tachykardia przedsionkowa występuje w wyniku nieprawidłowego automatyzmu i jest trudna do wywołania podczas badania elektrofizjologicznego, wymagając infuzji leków w celu indukcji.5 Mechanizm nawrotny zazwyczaj leży u podstaw makro-nawrotnej tachykardii przedsionkowej, jak na przykład trzepotanie przedsionków.6
Strukturalne przyczyny tachykardii przedsionkowej
Tachykardia przedsionkowa często występuje u osób z chorobami strukturalnymi serca, ale może również rozwinąć się u osób ze strukturalnie zdrowym sercem.7 Do głównych strukturalnych przyczyn zaliczamy:89
- Choroba niedokrwienna serca – niedokrwienie mięśnia sercowego może prowadzić do nieprawidłowej aktywności elektrycznej
- Kardiomiopatia – zmiany w mięśniu sercowym mogą zmieniać szlaki elektryczne serca
- Wrodzone wady serca – predysponują do rozwoju tachykardii przedsionkowej
- Blizny po operacjach kardiochirurgicznych – zwłaszcza po zabiegach na przedsionkach
- Choroba zastawkowa serca – może prowadzić do powiększenia przedsionków
- Stan po zawale serca – zmiany bliznowate mogą stanowić podłoże dla obwodów re-entry
Warto podkreślić, że tachykardia przedsionkowa jest szczególnie częsta u pacjentów po przebytych zabiegach kardiochirurgicznych, zwłaszcza po procedurze Fontana, gdzie może mieć potencjalnie zagrażające życiu konsekwencje.12 Również pacjenci po ablacji migotania przedsionków są narażeni na rozwój tachykardii przedsionkowej, najczęściej z powodu szczelin w liniach ablacyjnych.13
Pozastrukturalne przyczyny tachykardii przedsionkowej
Tachykardia przedsionkowa może być wywołana przez czynniki niezwiązane bezpośrednio ze strukturalnymi zmianami w sercu:1415
- Zaburzenia elektrolitowe – hipokaliemia, hipomagnezemia mogą zaburzać funkcję elektryczną serca
- Nadczynność tarczycy – zwiększona aktywność hormonów tarczycy może przyspieszać czynność serca
- Niedotlenienie (hipoksja) – często związane z chorobami płuc
- Nadmierna aktywacja układu współczulnego – stres, ból, wysiłek fizyczny
- Leki i substancje stymulujące:
- Kofeina
- Alkohol (spożywanie lub zespół odstawienia)
- Kokaina i inne substancje psychoaktywne
- Teofilina
- Leki beta-agonistyczne
- Inhibitory fosfodiesterazy
- Dobutamina i milrinon
- Zatrucie digoksyną – ważna przyczyna tachykardii przedsionkowej z aktywnością wyzwalaną
Zatrucie digoksyną jest szczególnie istotną przyczyną tachykardii przedsionkowej, gdzie mechanizm aktywności wyzwalanej odgrywa kluczową rolę. Tachykardia przedsionkowa z blokiem przewodzenia 2:1 powinna zawsze budzić podejrzenie toksycznego działania digoksyny.1819
Wieloogniskowa tachykardia przedsionkowa
Wieloogniskowa tachykardia przedsionkowa (MAT) jest specyficznym rodzajem tachykardii przedsionkowej, charakteryzującym się obecnością zorganizowanej aktywności przedsionkowej dającej załamki P o co najmniej trzech różnych morfologiach.20 MAT jest ściśle związana z chorobami płuc oraz innymi schorzeniami ogólnoustrojowymi.21
Przyczyny wieloogniskowej tachykardii przedsionkowej
Wieloogniskowa tachykardia przedsionkowa najczęściej występuje w następujących stanach:2223
- Choroby płuc:
- Przewlekła obturacyjna choroba płuc (POChP) – najczęstsza przyczyna (60-85% przypadków)
- Zaostrzenie niewydolności oddechowej
- Zatorowość płucna
- Zapalenie płuc
- Nowotwór płuc
- Choroby serca:
- Niewydolność serca
- Choroba wieńcowa
- Choroba zastawkowa
- Zaburzenia metaboliczne:
- Hipokaliemia
- Hipomagnezemia
- Azotemia
- Inne stany:
- Cukrzyca
- Stan po operacji (do 6 tygodni)
- Sepsa
- Toksyczność metylosantyn (teofilina)
MAT często pojawia się u osób powyżej 50. roku życia, szczególnie u tych z niedotlenieniem i stymulacją współczulną, zwykle w kontekście zaostrzenia chorób przewlekłych.26 Najbardziej charakterystyczne jest jej występowanie u pacjentów z POChP – według niektórych źródeł dotyczy ona nawet 20% pacjentów z ostrą niewydolnością oddechową i 17% hospitalizowanych z powodu POChP.27
Czynniki ryzyka tachykardii przedsionkowej
Czynniki ryzyka rozwoju tachykardii przedsionkowej obejmują:2829
- Wiek – ryzyko wzrasta wraz z wiekiem, szczególnie u osób w średnim i starszym wieku
- Choroby serca:
- Choroba wieńcowa
- Niewydolność serca
- Kardiomiopatia
- Wrodzone wady serca
- Przebyte operacje kardiochirurgiczne
- Choroby współistniejące:
- Nadciśnienie tętnicze
- Choroby płuc (zwłaszcza POChP)
- Zaburzenia tarczycy
- Cukrzyca
- Bezdech senny
- Czynniki modyfikowalne:
- Spożywanie alkoholu (zwłaszcza >15 drinków tygodniowo dla mężczyzn i >8 dla kobiet)
- Palenie tytoniu
- Kofeina
- Narkotyki (kokaina, metaamfetamina)
- Stres emocjonalny
- Leki:
- Leki stosowane w leczeniu astmy i alergii
- Leki na przeziębienie
- Leki rozszerzające oskrzela
- Leki obkurczające naczynia
U osób z predyspozycjami genetycznymi może występować idiopatyczna (samoistna) tachykardia przedsionkowa, szczególnie w młodszym wieku. Czynniki ryzyka arytmii są ogólnie podobne do czynników ryzyka rozwoju chorób serca, dlatego zdrowy styl życia, zbilansowana dieta, aktywność fizyczna i unikanie używek mają kluczowe znaczenie w prewencji.32
Szczególne rodzaje tachykardii przedsionkowej
Ogniskowa tachykardia przedsionkowa
Ogniskowa tachykardia przedsionkowa (FAT) charakteryzuje się szybkim, regularnym rytmem pochodzącym z określonego miejsca w przedsionkach.33 Może występować zarówno u osób ze strukturalnie prawidłowym sercem, jak i u pacjentów z chorobami serca. Do najważniejszych przyczyn należą:34
- Zatrucie digoksyną
- Blizny w mięśniu sercowym spowodowane chorobą niedokrwienną serca
- Nadmiar katecholamin
- Substancje stymulujące, w tym kokaina i kofeina
- Alkohol
- Wrodzone nieprawidłowości serca
- Przyczyny idiopatyczne
Przetrwała tachykardia przedsionkowa może prowadzić do kardiomiopatii tachyarytmicznej, co stanowi powikłanie rzadko spotykane, ale istotne klinicznie.36
Ektopowa tachykardia przedsionkowa
Ektopowa tachykardia przedsionkowa (EAT) występuje, gdy obszar komórek poza naturalnym rozrusznikiem serca zaczyna wysyłać sygnały elektryczne prowadzące do arytmii.37 Często występuje u osób z wrodzonymi wadami serca, jednak może również wystąpić u osób z prawidłową budową serca.38
U dzieci EAT jest spowodowana stosunkowo niedojrzałym miokardium i charakterystyką elektrofizjologiczną tkanki przewodzącej. Może występować zarówno w zdrowym sercu, jak i u pacjentów z wrodzonymi wadami serca, po operacjach serca, z zapaleniem mięśnia sercowego, dysplazją oskrzelowo-płucną, ciężkim nadciśnieniem płucnym i kardiomiopatią przerostową.39
U dorosłych EAT jest głównie spowodowana chorobowo zmienionym miokardium przedsionków i lokalnymi procesami degeneracyjnymi. Obserwowano ją również w przypadku ostrego zatrucia lekami (np. digoksyna, amfetaminy i trójcykliczne leki przeciwdepresyjne), ostrej i przewlekłej choroby serca, obturacyjnej choroby płuc, ostrej infekcji i różnych zaburzeń metabolicznych.40
Jatrogeniczne przyczyny tachykardii przedsionkowej
Tachykardia przedsionkowa może być również wynikiem interwencji medycznych:4142
- Ablacja migotania przedsionków – szczeliny w liniach ablacyjnych mogą tworzyć obwody re-entry
- Operacje kardiochirurgiczne – zwłaszcza na przedsionkach
- Leki proarytmiczne:
- Digoksyna (toksyczność)
- Beta-agoniści
- Inhibitory fosfodiesterazy
- Dobutamina
- Milrinon
- Teofilina
Jatrogeniczne tachykardie przedsionkowe stały się częstsze i zwykle są wynikiem zabiegów ablacyjnych w lewym przedsionku. Zidentyfikowano kilka typowych miejsc powstawania tych tachykardii, w tym cieśń mitralna (między lewą dolną żyłą płucną a pierścieniem mitralnym), dach lewego przedsionka oraz, w przypadku reentry, wokół żył płucnych.44
U pacjentów po transplantacji serca metodą bi-atrial może wystąpić niezwykle rzadka forma tachykardii przedsionkowej typu biorca-dawca, gdzie arytmia pochodzi z pozostałości przedsionka biorcy lub z reentry wokół linii szwów nacięcia i przerywa rytm serca dawcy.45
Konsekwencje tachykardii przedsionkowej
Przedłużająca się tachykardia przedsionkowa może prowadzić do szeregu powikłań:4647
- Kardiomiopatia tachyarytmiczna – osłabienie mięśnia sercowego w wyniku długotrwałego przyspieszenia rytmu serca
- Niewydolność serca – jako konsekwencja kardiomiopatii
- Negatywny remodeling przedsionków – powiększenie i osłabienie przedsionków
- Inicjacja i utrwalenie migotania przedsionków – tachykardia przedsionkowa może być prekursorem migotania przedsionków
- Zaburzenia hemodynamiczne – serce nie jest w stanie prawidłowo napełniać się krwią, co prowadzi do zmniejszenia rzutu serca
Szczególnie niebezpieczne są długotrwałe epizody (trwające miesiące lub lata) ciągłej tachykardii przedsionkowej z szybką czynnością komór (zazwyczaj powyżej 100 uderzeń na minutę), które mogą prowadzić do kardiomiopatii indukowanej tachykardią i objawów niewydolności serca.50
W ostatnich latach stało się jasne, że tachykardia przedsionkowa odgrywa istotną rolę w inicjacji i podtrzymywaniu migotania przedsionków, co dodatkowo podkreśla znaczenie odpowiedniego leczenia tego zaburzenia rytmu.51
Podsumowanie etiologii tachykardii przedsionkowej
Tachykardia przedsionkowa może być wynikiem różnorodnych czynników etiopatogenetycznych, od wrodzonych anomalii strukturalnych serca, przez choroby nabyte, po czynniki środowiskowe i jatrogeniczne. Najważniejsze przyczyny obejmują:5253
- Choroby strukturalne serca – choroba niedokrwienna, kardiomiopatia, wrodzone wady serca
- Choroby płuc – szczególnie POChP w przypadku wieloogniskowej tachykardii przedsionkowej
- Zaburzenia elektrolitowe i metaboliczne – hipokaliemia, hipomagnezemia
- Substancje stymulujące – kofeina, alkohol, kokaina
- Leki – digoksyna (toksyczność), beta-agoniści, inhibitory fosfodiesterazy
- Jatrogenne – po ablacji, operacjach kardiochirurgicznych
- Idiopatyczne – bez uchwytnej przyczyny, zwłaszcza ogniskowa tachykardia przedsionkowa u młodych osób
Zrozumienie etiologii tachykardii przedsionkowej ma kluczowe znaczenie dla wyboru odpowiedniej strategii leczenia. W wielu przypadkach leczenie choroby podstawowej może prowadzić do ustąpienia arytmii, co podkreśla znaczenie dokładnej diagnostyki przyczyn jej wystąpienia.56 Regularne kontrole kardiologiczne, unikanie czynników wyzwalających oraz zdrowy styl życia mogą znacząco zmniejszyć ryzyko nawrotów tej arytmii.57
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Materiały źródłowe
- #1 Atrial tachycardias – AF-ABLATIONhttps://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. Atrial tachycardia is an infrequent condition and accounts for 5-15% of all supraventricular tachycardias, and it is more frequent in patients with congenital heart disease or in post-surgical patients. […] Atrial tachycardias can be classified based on endocardial activation data, pathophysiological mechanisms, or anatomy. […] Based on the pathophysiological mechanism, atrial tachycardias can be classified into: tachycardia due to increased automatism, triggered activity, and re-entry. […] Many atrial structures can represent a substrate for arrhythmia. The orifices of the vena cava, the pulmonary veins, the coronary sinus, the atrial septum, the tricuspid, and the mitral annulus are potential anatomical barriers that can favor the re-entry circuits.
- #1 Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK542235/
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. In some cases, the mechanism remains undetermined. […] Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. […] Risk factors for arrhythmia are similar to risk factors for developing heart disease. A heart-healthy lifestyle with a well-balanced diet, exercising and refraining from tobacco products is essential for prevention. Focal atrial tachycardia persistence can be mitigated by the avoidance of caffeinated products and other stimulant substances.
- #2 Common Types of Supraventricular Tachycardia: Diagnosis and Management | AAFPhttps://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. […] Atrial tachycardia (AT) can result from one of the three mechanisms. […] The third most common type of SVT is AT (approximately 10 percent); it originates from a single atrial focus. […] Another form, multifocal AT, often occurs in patients with heart failure or chronic obstructive pulmonary disease. […] The coexistence of slow and fast pathways in atrioventricular nodal tissue is the basis of aberrant substrate for reentrant tachyarrhythmias. […] Patients with this arrhythmia typically present at a younger age than those with AVNRT. […] This SVT is caused by accessory pathways (or bypass tracts) that serve as aberrant conduits for impulses that pass from the sinoatrial node and travel in an antegrade or retrograde fashion through such tracts, establishing a reentry circuit.
- #2 Atrial tachycardias – AF-ABLATIONhttps://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. Atrial tachycardia is an infrequent condition and accounts for 5-15% of all supraventricular tachycardias, and it is more frequent in patients with congenital heart disease or in post-surgical patients. […] Atrial tachycardias can be classified based on endocardial activation data, pathophysiological mechanisms, or anatomy. […] Based on the pathophysiological mechanism, atrial tachycardias can be classified into: tachycardia due to increased automatism, triggered activity, and re-entry. […] Many atrial structures can represent a substrate for arrhythmia. The orifices of the vena cava, the pulmonary veins, the coronary sinus, the atrial septum, the tricuspid, and the mitral annulus are potential anatomical barriers that can favor the re-entry circuits.
- #3 Paroxysmal Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK538317/
Atrial tachycardia, with trigger origins, result from an electrolyte disturbance after an action potential. The error occurs by a calcium influx, originating from the other action potential, which causes depolarization. If the depolarization is significant enough, to reach the threshold, an action potential is generated. If this event is isolated, it may only result in an atrial ectopic beat, but if this electrolyte disturbance continues, it will produce a tachycardic arrhythmia. Catecholamine imbalance and digitalis toxicity are common trigger sources. Triggered atrial tachycardia can originate in one location in the atria or from multiple sites, which can result in a regular or irregular rhythm.
- #4 Ectopic atrial rhythm (EAT), atrial tachycardia (AT) & multifocal atrial tachycardia (MAT) – The Cardiovascularhttps://ecgwaves.com/topic/ectopic-atrial-rhythm-multifocal-tachycardia-multifocal/
Ectopic atrial tachycardia (EAT, or atrial tachycardia) arises when an ectopic focus within the atria generates electrical impulses at a rate exceeding that of the sinoatrial (SA) node. This enhanced atrial activity is most commonly attributable to abnormal automaticity or re-entry mechanisms; triggered activity is a less frequent cause. […] Ectopic atrial tachycardia (EAT) most commonly occurs in individuals with underlying structural or electrical heart disease. Less frequently, it may also present in individuals without identifiable cardiac disease. Contributing factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. […] Causes of ectopic atrial tachycardia and ectopic atrial rhythm include side effect of digoxin, heart failure, lung disease (COPD, pulmonary hypertension, etc), ischemic heart disease (coronary artery disease), and structural heart disease, any. […] Multifocal atrial tachycardia may be intermittent with intervening periods of sinus rhythm. The most common underlying causes are heart failure, atrial ischemia, increased atrial pressure, use of theophyllamine or chronic lung disease (particularly COPD).
- #5 Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK542235/
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. In some cases, the mechanism remains undetermined. […] Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. […] Risk factors for arrhythmia are similar to risk factors for developing heart disease. A heart-healthy lifestyle with a well-balanced diet, exercising and refraining from tobacco products is essential for prevention. Focal atrial tachycardia persistence can be mitigated by the avoidance of caffeinated products and other stimulant substances.
- #6 Atrial Tachycardia Treatment in Delhi, India | Symptoms & Causeshttps://www.blkmaxhospital.com/our-specialities/electrophysiology-arrhythmia-services/conditions-treatments/atrial-tachycardia
If the person has thyroid, an overactive or underactive thyroid gland can increase the risk of atrial tachycardia. […] The use of illegal drugs, such as amphetamines and cocaine, may induce atrial tachycardia. […] Atrial tachycardia may lead to cardiomyopathy (weakening of the heart muscle) and heart attack. […] Several pathophysiological mechanisms have been attributed to atrial tachycardia. These mechanisms can be differentiated based on the pattern of onset and termination and the response to drugs, and atrial pacing. Automatic atrial tachycardia arises due to enhanced tissue automaticity and is observed in patients with structurally normal hearts and those with organic heart disease. […] Triggered activity has features seen with enhanced automaticity, though they are felt to involve calcium channels primarily. Re-entry is typically the underlying mechanism in macro-reentrant atrial tachycardia, like an atrial flutter.
- #7 Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK542235/
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. In some cases, the mechanism remains undetermined. […] Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. […] Risk factors for arrhythmia are similar to risk factors for developing heart disease. A heart-healthy lifestyle with a well-balanced diet, exercising and refraining from tobacco products is essential for prevention. Focal atrial tachycardia persistence can be mitigated by the avoidance of caffeinated products and other stimulant substances.
- #8https://continentalhospitals.com/diseases/atrial-tachycardia/
Atrial tachycardia can be caused by a variety of factors and underlying conditions. Some common causes include: […] Structural abnormalities present from birth can predispose individuals to atrial tachycardia. […] Diseases of the heart muscle can alter the hearts electrical pathways. […] Reduced blood flow to the heart muscle can lead to abnormal electrical activity. […] Abnormal levels of these electrolytes can disrupt the normal electrical functions of the heart. […] Previous surgeries, especially those involving the atria, can create scar tissue that interferes with normal electrical pathways. […] Inflammation of the pericardium can affect the electrical activity in the atria. […] This can lead to structural changes and increased pressures within the heart, promoting arrhythmias.
- #9 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Atrial tachycardia can occur in individuals with structurally normal hearts or in patients with organic heart disease. When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, an atrial tachycardia can have potentially life-threatening consequences. […] The atrial tachycardia that manifests in association with exercise, acute illness with excessive catecholamine release, alcohol ingestion, altered fluid states, hypoxia, metabolic disturbance, or drug use (eg, caffeine, albuterol, theophylline, cocaine) is associated with automaticity or triggered activity. Digitalis intoxication is an important cause of atrial tachycardia, with triggered activity being the underlying mechanism. […] Reentrant atrial tachycardia tends to occur in patients with structural heart disease, including ischemic, congenital, postoperative, and valvular disorders. Iatrogenic atrial tachycardias have become more common and typically result from ablative procedures in the left atrium. Several typical origination sites for these tachycardias have been identified, including the mitral isthmus (between the left lower pulmonary vein and mitral annulus), the roof of the left atrium, and, for reentry, around the pulmonary veins.
- #10 Atrial Tachycardia | Columbia Surgeryhttps://columbiasurgery.org/conditions-and-treatments/atrial-tachycardia
Atrial tachycardia or atrial fibrillation happens when electrical signals in the atria are fired in a very fast and uncontrolled manner. […] Certain risk factors make it more likely to develop atrial fibrillation, but often the cause remains unclear. Leading risk factors include: coronary heart disease, heart attack, heart failure, medication and chemical changes, heart valve disease, endocarditis (inflamed heart muscle or lining), recent heart surgery, atherosclerosis (arteries lined with fatty deposits), angina (chest pain due to reduced blood flow to the heart muscle), a birth defect in the heart, severe lung disease, blood clots in the lung, emphysema, asthma. […] Gender and age also affect both the likelihood of developing atrial fibrillation and the severity of the condition. Men are slightly more likely than women to have atrial fibrillation, but women who are diagnosed with the disease have a greater risk over time for premature death. Older people are more likely to have atrial fibrillation than younger people. Additional risk factors include thyroid disorders, diabetes, high blood pressure, excessive alcohol intake, and cigarette or drug use (including caffeine).
- #11 Atrial Tachycardia: Symptoms, Causes, Treatmenthttps://www.healthline.com/health/atrial-tachycardia
Atrial tachycardia often affects people whove had heart surgery and those who were born with heart defects. […] Atrial tachycardia may result from structural problems in your heart that are either present from birth or develop later in life. People whove had heart surgery to treat another condition often develop this type of arrhythmia. […] Atrial tachycardia can also develop in people without structural heart problems. Potential triggers include: low blood oxygen levels, lung disease, heart disease, stimulants such as cocaine, caffeine, and ephedra, a high alcohol intake, digoxin toxicity.
- #12 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Atrial tachycardia can occur in individuals with structurally normal hearts or in patients with organic heart disease. When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, an atrial tachycardia can have potentially life-threatening consequences. […] The atrial tachycardia that manifests in association with exercise, acute illness with excessive catecholamine release, alcohol ingestion, altered fluid states, hypoxia, metabolic disturbance, or drug use (eg, caffeine, albuterol, theophylline, cocaine) is associated with automaticity or triggered activity. Digitalis intoxication is an important cause of atrial tachycardia, with triggered activity being the underlying mechanism. […] Reentrant atrial tachycardia tends to occur in patients with structural heart disease, including ischemic, congenital, postoperative, and valvular disorders. Iatrogenic atrial tachycardias have become more common and typically result from ablative procedures in the left atrium. Several typical origination sites for these tachycardias have been identified, including the mitral isthmus (between the left lower pulmonary vein and mitral annulus), the roof of the left atrium, and, for reentry, around the pulmonary veins.
- #13 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
The most common reason for postablation tachycardias is gaps in the ablation lines, allowing for slow conduction and initiation reentry circuits or circuits excluded by the set of ablation lines. Typically, these patients have undergone an atrial fibrillation ablation procedure. This is true for catheter ablation and surgical epicardial ablation. […] Similarly, patients with prior surgical procedures involving the left atrium may have surgical incision lines and, hence, the potential for macroreentrant circuits. […] MAT is often related to underlying illnesses, frequently occurring in patients experiencing an exacerbation of chronic obstructive pulmonary disease (COPD), a pulmonary thromboembolism, an exacerbation of heart failure, or severe illness, especially under critical care with inotropic infusion. MAT is often associated with hypoxia and sympathetic stimulation. Digitalis toxicity also may be present in persons with MAT, with triggered activity as the mechanism.
- #14 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Atrial tachycardia can occur in individuals with structurally normal hearts or in patients with organic heart disease. When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, an atrial tachycardia can have potentially life-threatening consequences. […] The atrial tachycardia that manifests in association with exercise, acute illness with excessive catecholamine release, alcohol ingestion, altered fluid states, hypoxia, metabolic disturbance, or drug use (eg, caffeine, albuterol, theophylline, cocaine) is associated with automaticity or triggered activity. Digitalis intoxication is an important cause of atrial tachycardia, with triggered activity being the underlying mechanism. […] Reentrant atrial tachycardia tends to occur in patients with structural heart disease, including ischemic, congenital, postoperative, and valvular disorders. Iatrogenic atrial tachycardias have become more common and typically result from ablative procedures in the left atrium. Several typical origination sites for these tachycardias have been identified, including the mitral isthmus (between the left lower pulmonary vein and mitral annulus), the roof of the left atrium, and, for reentry, around the pulmonary veins.
- #15 Atrial tachycardia – Wikipediahttps://en.wikipedia.org/wiki/Atrial_tachycardia
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Hypoxia […] Pulmonary disease […] Ischemic heart disease […] Stimulants: cocaine, caffeine, chocolate, ephedra […] Alcohol […] Metabolic disturbances […] Digoxin toxicity […] Heightened sympathetic tone.
- #16 Atrial Tachycardia: Diagnosis – The Cardiology Advisorhttps://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. […] 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. […] When FAT arises from reentrant electrical impulses, it is associated with structural heart disease. It may also occur incessantly due to enhanced automaticity in a structurally normal heart, a condition that can result in cardiomyopathy and heart failure. […] By contrast, MAT is closely associated with lung diseases, such as asthma or chronic obstructive pulmonary disease (COPD). It can also result from hypomagnesemia. […] Digoxin and theophylline are among the drugs that can cause atrial tachycardia. Others include -agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also provoke arrhythmia.
- #17 Tachycardia: Symptoms & Causes | NewYork-Presbyterianhttps://www.nyp.org/heart/arrhythmias/tachycardia
Causes of Atrial Tachycardia […] Not all forms of tachycardia are serious. Sinus tachycardia, for example, is the hearts natural, temporary response to stress, exercise, and dehydration. But some causes lead to more serious types of tachycardia. […] The common causes of atrial tachycardia or supraventricular tachycardia are: […] Stress […] Heavy alcohol consumption […] Excess caffeine […] Irregular blood pressure, high or low […] Electrolyte imbalance/dehydration […] Anemia/bleeding […] Hyperthyroidism (overactive thyroid) […] Smoking […] Stimulant use (methamphetamine and cocaine) […] Substance withdrawal.
- #18 Atrial Tachycardia – Paroxysmalhttps://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/atrial-tachycardia
Atrial tachycardia is a form of supraventricular tachycardia that occurs when one focus in the atria begins to fire rapidly, overwhelming the sinoatrial node. […] Causes of atrial tachycardia include chronic hypertension, congestive heart failure, valvular heart disease and, simply, aging of the heart. […] Atrial tachycardia with 2:1 block; when atrial tachycardia occurs with a 2:1 conduction block, digoxin toxicity should be considered.
- #19 Atrial tachycardias – AF-ABLATIONhttps://af-ablation.org/en/arrhythmological-disorders/supraventricular-tachycardia/atrial-tachycardia/
Automatic atrial tachycardia is found both in patients with a structurally healthy heart and in patients with underlying heart disease. […] Triggered atrial tachycardias are due to late post-depolarizations, which are made up of low voltage oscillations at the end of the action potential. […] Digitalis intoxication is an important cause of atrial tachycardia from triggered activity. […] Intra-atrial re-entry tachycardias can be due to both macro-reenteries and micro-indentations. […] 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. […] The choice of long-term therapy for patients with atrial tachycardia depends on the symptoms, the frequency of the episodes, and the underlying heart conditions.
- #20 Multifocal atrial tachycardia – UpToDatehttps://www.uptodate.com/contents/multifocal-atrial-tachycardia
Multifocal atrial tachycardia (MAT) is an arrhythmia that can be seen in a variety of clinical disorders. […] This topic will review the definition, pathogenesis, etiology, and treatment of MAT in adults. […] The key feature distinguishing MAT from other tachyarrhythmias of atrial origin is the presence of organized atrial activity yielding P waves with three or more different morphologies. […] A more accurate term for this arrhythmia is probably „multiform” as there is no proof that the arrhythmia is actually multifocal, although multifocal remains the commonly used term.
- #21 Atrial Tachycardia: Diagnosis – The Cardiology Advisorhttps://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. […] 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. […] When FAT arises from reentrant electrical impulses, it is associated with structural heart disease. It may also occur incessantly due to enhanced automaticity in a structurally normal heart, a condition that can result in cardiomyopathy and heart failure. […] By contrast, MAT is closely associated with lung diseases, such as asthma or chronic obstructive pulmonary disease (COPD). It can also result from hypomagnesemia. […] Digoxin and theophylline are among the drugs that can cause atrial tachycardia. Others include -agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also provoke arrhythmia.
- #22 Multifocal atrial tachycardia Information | Mount Sinai – New Yorkhttps://www.mountsinai.org/health-library/diseases-conditions/multifocal-atrial-tachycardia
Multifocal atrial tachycardia (MAT) is a rapid heart rate. It occurs when too many signals (electrical impulses) are sent from the upper heart (atria) to the lower heart (ventricles). […] MAT is most common in people age 50 and over. It is often seen in people with conditions that lower the amount of oxygen in the blood. These conditions include: Chronic obstructive pulmonary disease (COPD), Heart failure (also called congestive heart failure), Lung cancer, Lung failure, Pneumonia, Pulmonary embolism. […] You may be at higher risk for MAT if you have: Coronary heart disease, Diabetes, Had surgery within the last 6 weeks, Overdosed on the drug theophylline, Sepsis. […] To reduce the risk for developing MAT, treat the disorders that cause it right away.
- #23 Multifocal Atrial Tachycardia: Overview of Multifocal Atrial Tachycardia, Pathophysiology of MAT, Etiology of MAThttps://emedicine.medscape.com/article/155825-overview
Causes of multifocal atrial tachycardia (MAT) are mainly related to underlying illnesses. The following common underlying illnesses are associated with this arrhythmia: […] Decompensated chronic lung disease […] Coronary artery disease […] Heart failure […] Valvular heart disease […] Diabetes mellitus […] Hypokalemia […] Hypomagnesemia […] Azotemia […] Postoperative state […] Pulmonary embolism […] Pneumonia […] Sepsis […] Methylxanthine toxicity (theophylline toxicity).
- #24 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Other underlying conditions that are commonly associated with MAT are the following: Valvular heart disease, Diabetes mellitus, Hypokalemia, Hypomagnesemia, Azotemia, Postoperative state, Sepsis, Methylxanthine toxicity, Myocardial infarction, Pneumonia. […] Unusual forms of atrial tachycardias can be seen in patients with an infiltrative process involving the pericardium and, by extension, the atrial wall. […] A very unusual form of recipient-to-donor atrial tachycardia may be seen in patients who have undergone bi-atrial orthotropic cardiac transplantation. In this situation, atrial arrhythmia originates in the recipient remnant of the heart or from reentry around the incision suture lines and break through to the donor heart.
- #25 Multifocal Atrial Tachycardia: Causes, Symptoms, Diagnosis, Treatmenthttps://www.webmd.com/heart-disease/atrial-fibrillation/multifocal-atrial-tachycardia
Doctors dont know exactly what causes MAT. Part of the reason its poorly understood is that MAT isnt a very common type of arrhythmia. […] MAT usually happens in older people, with an average age of 70. But it sometimes also happens in children or young adults. Its more common in men and in people with one or more other health problems. These problems may include: Chronic lung disease, Acute respiratory failure, Coronary artery disease, Congestive heart failure, Diabetes, Chronic kidney failure, Pneumonia, Sepsis. […] Sometimes MAT happens in people after major surgery. It also can happen in people who have an imbalance of electrolytes, such as magnesium or potassium. People taking certain medications used to treat heart or lung problems may be more likely to have MAT.
- #26 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
The most common reason for postablation tachycardias is gaps in the ablation lines, allowing for slow conduction and initiation reentry circuits or circuits excluded by the set of ablation lines. Typically, these patients have undergone an atrial fibrillation ablation procedure. This is true for catheter ablation and surgical epicardial ablation. […] Similarly, patients with prior surgical procedures involving the left atrium may have surgical incision lines and, hence, the potential for macroreentrant circuits. […] MAT is often related to underlying illnesses, frequently occurring in patients experiencing an exacerbation of chronic obstructive pulmonary disease (COPD), a pulmonary thromboembolism, an exacerbation of heart failure, or severe illness, especially under critical care with inotropic infusion. MAT is often associated with hypoxia and sympathetic stimulation. Digitalis toxicity also may be present in persons with MAT, with triggered activity as the mechanism.
- #27 Multifocal Atrial Tachycardia – MD Searchlighthttps://mdsearchlight.com/heart-health/multifocal-atrial-tachycardia/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=25345
Multifocal atrial tachycardia is a type of irregular heartbeat that is often linked to other underlying health conditions. These can include issues with the lungs, heart, imbalance in essential nutrients in the body (such as low potassium or magnesium levels), medication use, or long-term kidney disease. […] In fact, roughly 60% of individuals experiencing this irregular heartbeat also have significant lung disease. Additionally, its found in 20% of people with a severe breathing disorder called acute respiratory failure, and in 17% of patients who are hospitalized with a lung condition known as COPD. […] Other conditions linked to multifocal atrial tachycardia include heart disease, heart failure, diabetes, following major surgery, high blood pressure in the lung arteries, and from using certain medications like aminophylline, theophylline, and isoproterenol.
- #28 Atrial tachycardia | Beacon Health Systemhttps://www.beaconhealthsystem.org/library/diseases-and-conditions/atrial-tachycardia?content_id=CON-20239503
Atrial tachycardia is caused by faulty electrical signals in the heart. These electrical signals control the heartbeat. […] In atrial tachycardia, a change in these signals makes the heartbeat start too early in the heart’s upper chambers. This causes the heart to beat too fast. Then the heart is not able to fill with blood properly. […] Atrial tachycardia risk factors include: heart conditions such as coronary artery disease, heart valve disease and other heart diseases, heart failure, heart condition present at birth, called a congenital heart defect, previous heart surgery, sleep apnea, thyroid disease, lung disease, including chronic obstructive pulmonary disease (COPD), diabetes, some medicines, including those used to treat asthma, allergies and colds. […] Other things that may increase the risk of atrial tachycardia include: emotional stress, too much caffeine, heavy alcohol use, defined as more than 15 drinks a week for men and eight or more drinks a week for women, smoking and nicotine use, stimulant drugs, including cocaine and methamphetamine.
- #29 Atrial tachycardia | UM Health-Sparrowhttps://www.uofmhealthsparrow.org/departments-conditions/conditions/atrial-tachycardia
Atrial tachycardia is caused by faulty electrical signals in the heart. These electrical signals control the heartbeat. […] In atrial tachycardia, a change in these signals makes the heartbeat start too early in the heart’s upper chambers. This causes the heart to beat too fast. Then the heart is not able to fill with blood properly. […] Atrial tachycardia risk factors include: Heart conditions such as coronary artery disease, heart valve disease and other heart diseases. Heart failure. Heart condition present at birth, called a congenital heart defect. Previous heart surgery. Sleep apnea. Thyroid disease. Lung disease, including chronic obstructive pulmonary disease (COPD). Diabetes. Some medicines, including those used to treat asthma, allergies and colds. […] Other things that may increase the risk of atrial tachycardia include: Emotional stress. Too much caffeine. Heavy alcohol use, defined as more than 15 drinks a week for men and eight or more drinks a week for women. Smoking and nicotine use. Stimulant drugs, including cocaine and methamphetamine.
- #30https://continentalhospitals.com/diseases/atrial-tachycardia/
There are several factors that can contribute to the development of atrial tachycardia. One common cause is abnormal electrical pathways within the heart, which can disrupt the normal rhythm and result in rapid heartbeats. This can be due to congenital abnormalities or acquired conditions such as heart disease or previous cardiac surgeries. […] Another potential cause of atrial tachycardia is excessive stimulation of the heart’s electrical system. […] Several factors contribute to the development of atrial tachycardia. One significant risk factor is age, as the incidence of this condition tends to increase with advancing age. Additionally, individuals with a history of heart disease or structural abnormalities in the heart are at a higher risk for developing atrial tachycardia. Other risk factors include hypertension (high blood pressure), obesity, diabetes, and thyroid disorders. These conditions can disrupt the normal electrical impulses within the heart, leading to abnormal rhythms such as atrial tachycardia.
- #31 Atrial Tachycardia | Cardiology | Bon Secourshttps://www.bonsecours.com/health-care-services/heart-care-cardiology/conditions/atrial-tachycardia
Atrial tachycardia may be caused by: […] Heart disease or previous heart surgery. […] Lung conditions like COPD or pulmonary embolism. […] Stimulants, such as caffeine, alcohol, or certain drugs. […] Electrolyte imbalances, like low potassium or magnesium. […] Structural heart changes, including atrial enlargement or scarring. […] The following factors can increase your risk of atrial tachycardia: […] A history of heart disease, heart failure, or previous heart surgery. […] Chronic lung diseases, such as COPD or pulmonary embolism. […] Excessive consumption of alcohol or caffeine. […] Electrolyte imbalances or dehydration. […] A family history of arrhythmias or other heart conditions.
- #32 Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK542235/
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. In some cases, the mechanism remains undetermined. […] Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. […] Risk factors for arrhythmia are similar to risk factors for developing heart disease. A heart-healthy lifestyle with a well-balanced diet, exercising and refraining from tobacco products is essential for prevention. Focal atrial tachycardia persistence can be mitigated by the avoidance of caffeinated products and other stimulant substances.
- #33 Focal atrial tachycardia – Symptoms, diagnosis and treatment | BMJ Best Practice UShttps://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. […] Focal AT is characterized as a rapid regular rhythm arising from a discrete area within the atria. It occurs in a wide range of clinical conditions, including catecholamine excess, digoxin toxicity, congenital heart disease, and cardiomyopathy. […] Risk factors include substance misuse (alcohol ingestion/withdrawal, cocaine, amphetamines), digoxin toxicity, previous cardiac surgery to correct congenital heart defects, coronary artery disease, exacerbation of chronic lung disease, and theophylline.
- #34 Focal Atrial Tachycardia (FAT) • LITFL • ECG Library Diagnosishttps://litfl.com/atrial-tachycardia-ecg-library/
Focal atrial tachycardia (FAT) is a form of supraventricular tachycardia (SVT) originating from a single ectopic focus within the atria but outside of the sinus node. […] The underlying mechanism can involve increased automaticity, triggered activity or reentry. […] Multiple causes including: Digoxin toxicity, Atrial scarring due to ischaemic heart disease, Catecholamine excess, Stimulants including cocaine, caffeine, Alcohol, Congenital abnormalities, Idiopathic. […] Sustained atrial tachycardia may rarely be seen and can progress to tachycardia-induced cardiomyopathy.
- #35 Focal atrial tachycardia – UpToDatehttps://www.uptodate.com/contents/focal-atrial-tachycardia
Focal ATs (also referred to as atrial ectopic tachycardias) arise from a single site within the left or right atrium, in contrast to macroreentrant atrial arrhythmias (eg, atrial flutter) and atrial fibrillation, which involve multiple sites or larger circuits. […] In the past, focal ATs were considered to be due predominantly to enhanced automaticity. Thus, they were often referred to as automatic ATs. However, the more inclusive term focal AT is preferred, as this encompasses automatic, triggered, and microreentrant etiologies that cannot be distinguished easily on the surface electrocardiogram.
- #36 Focal Atrial Tachycardia (FAT) • LITFL • ECG Library Diagnosishttps://litfl.com/atrial-tachycardia-ecg-library/
Focal atrial tachycardia (FAT) is a form of supraventricular tachycardia (SVT) originating from a single ectopic focus within the atria but outside of the sinus node. […] The underlying mechanism can involve increased automaticity, triggered activity or reentry. […] Multiple causes including: Digoxin toxicity, Atrial scarring due to ischaemic heart disease, Catecholamine excess, Stimulants including cocaine, caffeine, Alcohol, Congenital abnormalities, Idiopathic. […] Sustained atrial tachycardia may rarely be seen and can progress to tachycardia-induced cardiomyopathy.
- #37 Ectopic Atrial Tachycardia: Symptoms, Causes, and Treatment Optionshttps://www.healthline.com/health/ectopic-atrial-tachycardia
EAT occurs when an area of cells outside the hearts natural pacemaker begins to send out electrical signals, leading to arrhythmia. […] EAT happens when an area of cells in your atria other than the SA node begins to produce electrical signals. These cells can make signals faster than the SA node, leading to an irregular and too-fast heart rate. […] It can often happen in people with congenital heart disease. However, people with a structurally normal heart can also have EAT. […] People born with congenital heart disease are more likely to develop EAT. It can also happen following surgery for congenital heart disease.
- #38 Incessant Ectopic Atrial Tachycardia Accompanied by Unusual Neurological Manifestations – Case Report and Literature Reviewhttps://seriesscience.com/ectopic-atrial-tachycardia/
Ectopic atrial tachycardia (EAT) is defined as the development of ectopic focus in one of the atria that conduct impulses at a higher rate than the sinoatrial node. This is attributed to abnormal automaticity, micro-reentry, or triggered activity taking place in the ectopic focus. […] Little is known about the etiology of the disease. In children, EAT is caused by the relatively immature myocardium and electrophysiologic characteristics of conduction tissue. It has been found in healthy hearts as well as in patients with congenital heart disease, post-cardiac surgery, myocarditis, bronchopulmonary dysplasia, severe pulmonary hypertension, and hypertrophic cardiomyopathy. In adults, EAT is primarily caused by diseased atrial myocardium and local degenerative processes that do not regress. Also, it has been observed with acute drug intoxication (for example, digitalis, amphetamines, and tricyclic antidepressants), acute and chronic heart disease, obstructive pulmonary disease, acute infection, and a variety of metabolic disorders.
- #39 Incessant Ectopic Atrial Tachycardia Accompanied by Unusual Neurological Manifestations – Case Report and Literature Reviewhttps://seriesscience.com/ectopic-atrial-tachycardia/
Ectopic atrial tachycardia (EAT) is defined as the development of ectopic focus in one of the atria that conduct impulses at a higher rate than the sinoatrial node. This is attributed to abnormal automaticity, micro-reentry, or triggered activity taking place in the ectopic focus. […] Little is known about the etiology of the disease. In children, EAT is caused by the relatively immature myocardium and electrophysiologic characteristics of conduction tissue. It has been found in healthy hearts as well as in patients with congenital heart disease, post-cardiac surgery, myocarditis, bronchopulmonary dysplasia, severe pulmonary hypertension, and hypertrophic cardiomyopathy. In adults, EAT is primarily caused by diseased atrial myocardium and local degenerative processes that do not regress. Also, it has been observed with acute drug intoxication (for example, digitalis, amphetamines, and tricyclic antidepressants), acute and chronic heart disease, obstructive pulmonary disease, acute infection, and a variety of metabolic disorders.
- #40 Incessant Ectopic Atrial Tachycardia Accompanied by Unusual Neurological Manifestations – Case Report and Literature Reviewhttps://seriesscience.com/ectopic-atrial-tachycardia/
Ectopic atrial tachycardia (EAT) is defined as the development of ectopic focus in one of the atria that conduct impulses at a higher rate than the sinoatrial node. This is attributed to abnormal automaticity, micro-reentry, or triggered activity taking place in the ectopic focus. […] Little is known about the etiology of the disease. In children, EAT is caused by the relatively immature myocardium and electrophysiologic characteristics of conduction tissue. It has been found in healthy hearts as well as in patients with congenital heart disease, post-cardiac surgery, myocarditis, bronchopulmonary dysplasia, severe pulmonary hypertension, and hypertrophic cardiomyopathy. In adults, EAT is primarily caused by diseased atrial myocardium and local degenerative processes that do not regress. Also, it has been observed with acute drug intoxication (for example, digitalis, amphetamines, and tricyclic antidepressants), acute and chronic heart disease, obstructive pulmonary disease, acute infection, and a variety of metabolic disorders.
- #41 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
The most common reason for postablation tachycardias is gaps in the ablation lines, allowing for slow conduction and initiation reentry circuits or circuits excluded by the set of ablation lines. Typically, these patients have undergone an atrial fibrillation ablation procedure. This is true for catheter ablation and surgical epicardial ablation. […] Similarly, patients with prior surgical procedures involving the left atrium may have surgical incision lines and, hence, the potential for macroreentrant circuits. […] MAT is often related to underlying illnesses, frequently occurring in patients experiencing an exacerbation of chronic obstructive pulmonary disease (COPD), a pulmonary thromboembolism, an exacerbation of heart failure, or severe illness, especially under critical care with inotropic infusion. MAT is often associated with hypoxia and sympathetic stimulation. Digitalis toxicity also may be present in persons with MAT, with triggered activity as the mechanism.
- #42 Atrial tachycardia | Royal Brompton & Harefield hospitalshttps://www.rbht.nhs.uk/our-services/atrial-tachycardia
Atrial tachycardia (AT) is an abnormal heart rhythm, but unlike atrial fibrillation (AF) it is more regular and organised. […] AT also comes from the top chambers (atria) of the heart, from either the right side, left side or both. We normally see this in patients who have: […] undergone heart surgery […] congenital heart defects […] undergone previous ablation procedures.
- #43 Atrial Tachycardia: Diagnosis – The Cardiology Advisorhttps://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. […] 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. […] When FAT arises from reentrant electrical impulses, it is associated with structural heart disease. It may also occur incessantly due to enhanced automaticity in a structurally normal heart, a condition that can result in cardiomyopathy and heart failure. […] By contrast, MAT is closely associated with lung diseases, such as asthma or chronic obstructive pulmonary disease (COPD). It can also result from hypomagnesemia. […] Digoxin and theophylline are among the drugs that can cause atrial tachycardia. Others include -agonists, phosphodiesterase inhibitors, dobutamine, and milrinone. Substances such as caffeine, cocaine, amphetamines, and alcohol use or withdrawal may also provoke arrhythmia.
- #44 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Atrial tachycardia can occur in individuals with structurally normal hearts or in patients with organic heart disease. When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, an atrial tachycardia can have potentially life-threatening consequences. […] The atrial tachycardia that manifests in association with exercise, acute illness with excessive catecholamine release, alcohol ingestion, altered fluid states, hypoxia, metabolic disturbance, or drug use (eg, caffeine, albuterol, theophylline, cocaine) is associated with automaticity or triggered activity. Digitalis intoxication is an important cause of atrial tachycardia, with triggered activity being the underlying mechanism. […] Reentrant atrial tachycardia tends to occur in patients with structural heart disease, including ischemic, congenital, postoperative, and valvular disorders. Iatrogenic atrial tachycardias have become more common and typically result from ablative procedures in the left atrium. Several typical origination sites for these tachycardias have been identified, including the mitral isthmus (between the left lower pulmonary vein and mitral annulus), the roof of the left atrium, and, for reentry, around the pulmonary veins.
- #45 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Other underlying conditions that are commonly associated with MAT are the following: Valvular heart disease, Diabetes mellitus, Hypokalemia, Hypomagnesemia, Azotemia, Postoperative state, Sepsis, Methylxanthine toxicity, Myocardial infarction, Pneumonia. […] Unusual forms of atrial tachycardias can be seen in patients with an infiltrative process involving the pericardium and, by extension, the atrial wall. […] A very unusual form of recipient-to-donor atrial tachycardia may be seen in patients who have undergone bi-atrial orthotropic cardiac transplantation. In this situation, atrial arrhythmia originates in the recipient remnant of the heart or from reentry around the incision suture lines and break through to the donor heart.
- #46 Atrial tachycardia: Symptoms, causes, treatment, and morehttps://www.medicalnewstoday.com/articles/atrial-tachycardia
Atrial tachycardia is a type of irregular heart rhythm that doctors call an arrhythmia. […] Atrial tachycardia is an arrhythmia with a heart rate greater than 100 beats per minute that originates in the atria, or two upper chambers, of the heart. […] However, it may occur due to other underlying health conditions, including structural heart disease and ischemic coronary artery disease. […] People without heart disease may develop atrial tachycardia. But often, it is a sign of an underlying condition, such as coronary artery disease and structural irregularities in the heart, which may be present at birth or develop over time. […] Some other factors may also trigger episodes of atrial tachycardia, including: low levels of oxygen in the blood, consuming stimulants, such as caffeine or cocaine, drinking large amounts of alcohol, lung disease, metabolic issues, such as nutrient imbalances, certain medications. […] Over time, atrial tachycardia may damage the heart. This can cause cardiomyopathy, which is a disease that weakens a person’s heart muscle. […] Atrial tachycardia is a type of SVT.
- #47 Atrial Tachycardiahttps://www.washingtonhra.com/arrhythmias/atrial-tachycardia.php
Atrial tachycardia is seen in patients both with and without structural heart disease. It can originate from virtually any focus or spot in the left or right atrium, with abnormal atrial tissue firing. […] There is no definitive answer as to why AT occurs in some persons and not others. […] Prolonged episodes (typically man months or years) of continuous atrial tachycardia can be problematic. Atrial tachycardia can cause irreversible changes to the atria, including negative remodeling with atrial enlargement and weakness (myopathy). […] Long-lasting atrial tachycardia with continuously rapid ventricular rates (heart rates typically greater than 100 beats per minute) may cause a tachycardia-induced cardiomyopathy (weakening of ventricular muscle and heart function) and symptoms of congestive heart failure. […] In recent years, the significance of AT in the initiation and perpetuation of atrial fibrillation has become apparent.
- #48 Atrial Tachycardia Treatment in Delhi, India | Symptoms & Causeshttps://www.blkmaxhospital.com/our-specialities/electrophysiology-arrhythmia-services/conditions-treatments/atrial-tachycardia
If the person has thyroid, an overactive or underactive thyroid gland can increase the risk of atrial tachycardia. […] The use of illegal drugs, such as amphetamines and cocaine, may induce atrial tachycardia. […] Atrial tachycardia may lead to cardiomyopathy (weakening of the heart muscle) and heart attack. […] Several pathophysiological mechanisms have been attributed to atrial tachycardia. These mechanisms can be differentiated based on the pattern of onset and termination and the response to drugs, and atrial pacing. Automatic atrial tachycardia arises due to enhanced tissue automaticity and is observed in patients with structurally normal hearts and those with organic heart disease. […] Triggered activity has features seen with enhanced automaticity, though they are felt to involve calcium channels primarily. Re-entry is typically the underlying mechanism in macro-reentrant atrial tachycardia, like an atrial flutter.
- #49 Atrial Tachycardia: Causes, Symptoms, Diagnosis, and Treatmenthttps://angolodeldottorino.it/Eng/Medicine/Cardiology/heart-rhythm-disorders/atrial-tachycardia.php
Metabolic and electrolyte imbalances also contribute to atrial tachycardia development. […] The development of atrial tachycardia is influenced by various predisposing factors that alter myocardial electrical stability or modify its response to stimuli. […] Key risk factors include advanced age, structural heart disease, chronic pulmonary diseases, metabolic and endocrine imbalances, and use of stimulating substances. […] The prognosis of atrial tachycardia varies depending on the underlying cause and treatment response. […] In patients with structural heart disease, atrial tachycardia may contribute to the progression of heart failure and increase the risk of transitioning to atrial fibrillation.
- #50 Atrial Tachycardiahttps://www.washingtonhra.com/arrhythmias/atrial-tachycardia.php
Atrial tachycardia is seen in patients both with and without structural heart disease. It can originate from virtually any focus or spot in the left or right atrium, with abnormal atrial tissue firing. […] There is no definitive answer as to why AT occurs in some persons and not others. […] Prolonged episodes (typically man months or years) of continuous atrial tachycardia can be problematic. Atrial tachycardia can cause irreversible changes to the atria, including negative remodeling with atrial enlargement and weakness (myopathy). […] Long-lasting atrial tachycardia with continuously rapid ventricular rates (heart rates typically greater than 100 beats per minute) may cause a tachycardia-induced cardiomyopathy (weakening of ventricular muscle and heart function) and symptoms of congestive heart failure. […] In recent years, the significance of AT in the initiation and perpetuation of atrial fibrillation has become apparent.
- #51 Atrial Tachycardiahttps://www.washingtonhra.com/arrhythmias/atrial-tachycardia.php
Atrial tachycardia is seen in patients both with and without structural heart disease. It can originate from virtually any focus or spot in the left or right atrium, with abnormal atrial tissue firing. […] There is no definitive answer as to why AT occurs in some persons and not others. […] Prolonged episodes (typically man months or years) of continuous atrial tachycardia can be problematic. Atrial tachycardia can cause irreversible changes to the atria, including negative remodeling with atrial enlargement and weakness (myopathy). […] Long-lasting atrial tachycardia with continuously rapid ventricular rates (heart rates typically greater than 100 beats per minute) may cause a tachycardia-induced cardiomyopathy (weakening of ventricular muscle and heart function) and symptoms of congestive heart failure. […] In recent years, the significance of AT in the initiation and perpetuation of atrial fibrillation has become apparent.
- #52 Atrial Tachycardia: Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/151456-overview
Atrial tachycardia can occur in individuals with structurally normal hearts or in patients with organic heart disease. When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, an atrial tachycardia can have potentially life-threatening consequences. […] The atrial tachycardia that manifests in association with exercise, acute illness with excessive catecholamine release, alcohol ingestion, altered fluid states, hypoxia, metabolic disturbance, or drug use (eg, caffeine, albuterol, theophylline, cocaine) is associated with automaticity or triggered activity. Digitalis intoxication is an important cause of atrial tachycardia, with triggered activity being the underlying mechanism. […] Reentrant atrial tachycardia tends to occur in patients with structural heart disease, including ischemic, congenital, postoperative, and valvular disorders. Iatrogenic atrial tachycardias have become more common and typically result from ablative procedures in the left atrium. Several typical origination sites for these tachycardias have been identified, including the mitral isthmus (between the left lower pulmonary vein and mitral annulus), the roof of the left atrium, and, for reentry, around the pulmonary veins.
- #53 Atrial tachycardia – Wikipediahttps://en.wikipedia.org/wiki/Atrial_tachycardia
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Hypoxia […] Pulmonary disease […] Ischemic heart disease […] Stimulants: cocaine, caffeine, chocolate, ephedra […] Alcohol […] Metabolic disturbances […] Digoxin toxicity […] Heightened sympathetic tone.
- #54 Atrial Tachycardia: Symptoms, Causes, Treatment | Qwarkhttps://qwarkhealth.com/conditions/atrial-tachycardia
Atrial tachycardia is a type of cardiac arrhythmia that involves the atria, the two upper chambers of the heart. […] The condition is caused by abnormal electrical signals in the heart, which can result from various factors such as medications, heart disease, or structural abnormalities in the heart. […] The most common cause of atrial tachycardia is an abnormal electrical impulse in the heart’s atria, which causes the heart to beat too fast. This can be caused by various factors, including heart disease, hypertension, lung disease, obesity, alcohol consumption, and thyroid problems. […] Yes, lifestyle factors such as alcohol consumption can contribute to atrial tachycardia. […] Underlying heart conditions that can lead to atrial tachycardia include coronary artery disease, heart failure, valve disease, and congenital heart defects.
- #55 Atrial Tachycardia: Causes, Symptoms, Diagnosis, and Treatmenthttps://angolodeldottorino.it/Eng/Medicine/Cardiology/heart-rhythm-disorders/atrial-tachycardia.php
Atrial tachycardia is a heart rhythm disorder characterized by an increased heart rate originating from an ectopic atrial focus, distinct from the sinoatrial node. […] The underlying causes can be categorized into structural abnormalities, autonomic nervous system modifications, and metabolic and electrolyte factors. […] Structural abnormalities, such as ischemic heart disease, valvular diseases, and cardiomyopathies, lead to atrial myocardial remodeling, resulting in fibrosis and heterogeneous electrical conduction. […] Chronic pulmonary diseases, such as COPD and pulmonary hypertension, also contribute to atrial remodeling, inducing right atrial dilation and altering the normal balance between sympathetic and vagal tone. […] Beyond structural factors, autonomic nervous system modifications play a key role in atrial tachycardia pathogenesis.
- #56 Atrial Tachycardia: Symptoms, Causes & Treatmenthttps://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia
Atrial tachycardia is a type of arrhythmia an irregular heart rhythm that causes the upper chambers (atria) of your heart to beat faster than normal. This condition has several possible causes, but usually isnt dangerous. Its often curable or manageable with medication. […] There are several potential causes of atrial tachycardia. Some of these include: Coronary artery disease and other types of heart disease. Heart attack. COPD. Electrolyte imbalances. Alcohol. Toxic effects of digoxin (a medication that can treat heart rhythm problems). Caffeine and other stimulants (including recreational drugs). […] Atrial tachycardia is often curable. When a chronic disease is the cause, treating that disease can often make atrial tachycardia stop.
- #57 Atrial Tachycardia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK542235/
Atrial tachycardia tends to occur in individuals with structural heart disease, with or without heart failure, and ischemic coronary artery disease. However, focal atrial tachycardia often occurs in healthy individuals without structural heart disease. Other possible etiologies are listed below: […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. In some cases, the mechanism remains undetermined. […] Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. […] Risk factors for arrhythmia are similar to risk factors for developing heart disease. A heart-healthy lifestyle with a well-balanced diet, exercising and refraining from tobacco products is essential for prevention. Focal atrial tachycardia persistence can be mitigated by the avoidance of caffeinated products and other stimulant substances.