Materiały źródłowe

• #1 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  The primary treatment during an episode of atrial tachycardia is considered to be rate control using atrioventricular (AV) nodal blocking agents (eg, beta-blockers or calcium channel blockers). […] In the setting of hemodynamic compromise due to SVT or known atrial tachycardia in which a drug may be therapeutic, the ultra short-acting agent adenosine or the short-acting beta-blocker esmolol may be tried. […] Atrial tachycardia often self-terminates and may be nonsustained if the cause is addressed. […] In patients with documented systolic dysfunction and symptoms of heart failure, elimination of the tachycardia by ablation can afford reversal of systolic dysfunction and resolution of heart failure symptoms. […] For any patient who does not tolerate the rhythm well hemodynamically and in whom rate control drugs are ineffective or contraindicated, cardioversion should be considered.

• #1 Atrial Tachycardia – StatPearls – NCBI Bookshelf

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

  Atrial tachycardia is an arrhythmia with electrical impulses originating within the atria. […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. […] The focus of this activity will be on focal atrial tachycardia (FAT). […] 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. […] The ventricular rate is controllable with the use of beta blockers or calcium channel blockers. […] If atrial tachyarrhythmia persists and the patient is symptomatic, the patient may benefit from class IA, IC, or class III antiarrhythmics.

• #1 Atrial tachycardia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/atrial-tachycardia

  Treatment of atrial tachycardia depends on what causes it and how severe it is. Treatment may include: […] Vagal maneuvers. Simple but specific actions such as coughing, putting an ice pack on the face or pushing down as if having a bowel movement can help slow down the heart rate. These actions affect the vagus nerve, which helps control the heartbeat. […] Medicines. Medicines may be given to control the heart rate and reset the heart rhythm. Some medicines may need to be given by IV. […] Cardioversion. Paddles or patches on the chest are used to give an electrical shock to the heart. The quick, low-energy shock resets the heart’s rhythm. This may be a treatment option if atrial tachycardia doesn’t get better with vagal maneuvers or medicine. […] Catheter ablation. A doctor guides a thin, flexible tube called a catheter through a blood vessel, usually in the groin, and up to the heart. Sometimes more than one catheter is used. Sensors on the tip of the catheter use heat energy, called radiofrequency energy, to create tiny scars in the heart. The scar tissue blocks faulty electrical signals. This restores a regular heartbeat.

• #1 Atrial tachycardias – AF-ABLATION

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

  What is the therapy for atrial tachycardias? […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. The Valsalva manoeuvre, the carotid sinus massage, and acupressure of the eyeballs, causing a slowing of the conduction are potentially effective in interrupting the arrhythmia: these interventions are generally less effective than in NRT or AVRT. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. On the other hand, adenosine in bolus i.v. is basically ineffective in atrial tachycardia and sinus re-entry tachycardia. Beta-blocker drugs, such as metoprolol or esmolol, can also be tried and are effective, in particular, in tachycardia due to increased automatism. […] The external electrical cardioversion is instead used in case of compromise of the hemodynamic state, when the patient is hypotensive, is in pulmonary edema, or experiences chest pain. 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. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #1 Atrial Tachycardia: Symptoms, Causes & Treatment

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

  Medications that providers often use to treat atrial tachycardia include: Beta-blockers: This type of medication can stop or slow down certain cell functions, especially in your heart. […] Calcium channel blockers: These change the way your heart muscle cells use calcium. This can reduce how sensitive your heart muscle cells are to an electrical signal. […] Ablation is another common atrial tachycardia treatment. Ablation treats certain areas of your heart to stop them from improperly conducting electricity. […] Catheter ablation: Your provider inserts a device into a major blood vessel (usually near your groin). Then, they thread it up to your heart to treat the problem area. […] Surgical ablation: If your provider cant fix your issue with catheter ablation, they may do surgery. Surgical approaches use similar methods but access the heart through an incision in your chest.

• #1 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  Atrial tachycardia from triggered activity (most frequently found in the setting of digitalis toxicity) is sensitive to verapamil, beta-blockers, and adenosine. […] For refractory recurrent atrial tachycardias causing symptoms (particularly recurrence after electrical cardioversion), antiarrhythmic drugs have been tried. […] Class III antiarrhythmic drugs such as amiodarone, sotalol, dronedarone, and dofetilide have variable efficacy in terminating atrial tachycardia. […] Atrial tachycardia due to digitalis intoxication often manifests as AV conduction block, ventricular arrhythmias, or both. […] In patients with multifocal atrial tachycardia (MAT), treatment and/or reversal of the precipitating cause may be the only therapy that is required; however, the arrhythmia may recur if the underlying condition worsens.

• #1 Atrial Tachycardia: Diagnosis and Treatment – Dermatology Advisor

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

  The treatment of atrial tachycardias is focused on rhythm control and prevention of arrhythmia recurrence. Persistent tachycardias with hemodynamic compromise must be terminated emergently with electrical cardioversion. […] The treatment could be pharmacologic or catheter based ablation. The patient should participate in the decision of which strategy to use as long as he or she can be a candidate for both. Patients with multiple comorbidities and contraindications for antiarrhythmic drugs should be treated with an invasive strategy, and patients with vascular access problems, contraindication to sedatives, and inability to safely withstand an ablation procedure should be treated with a conservative approach until they can be candidates for an invasive procedure. […] Pharmacologic therapy includes beta-blockers, calcium channel blockers, and antiarrhythmic drugs. Among antiarrhythmic drugs, class IC seem to be particularly effective with focal atrial tachycardias, but its use is limited to patients without myocardial scar and by extension, patients without coronary artery disease or significant structural heart disease.

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

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html/1000

  Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. […] Vagal maneuvers may terminate the arrhythmia; if this fails, adenosine is effective in the acute setting. Calcium channel blockers (diltiazem or verapamil) or beta blockers (metoprolol) can be used acutely or as long-term therapy. Class Ic antiarrhythmics (flecainide or propafenone) can be used long-term. Class Ia antiarrhythmics (quinidine, procainamide, or disopyramide) are used less often because of their modest effectiveness and adverse effects. Class III antiarrhythmics (amiodarone, sotalol, or dofetilide) are effective, but have potential adverse effects and should be administered in consultation with a cardiologist. Catheter ablation has a success rate of 95% and recurrence rate of less than 5%, and causes inadvertent heart block in less than 1% of patients. It is the preferred treatment for symptomatic patients with Wolff-Parkinson-White syndrome.

• #1 Multifocal atrial tachycardia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000186.htm

  If you have a condition that can lead to MAT, that condition should be treated first. […] Treatment for MAT includes: […] Improving blood oxygen levels […] Giving magnesium or potassium through a vein […] Stopping medicines, such as theophylline, which can increase heart rate […] Taking medicines to slow the heart rate (if the heart rate is too fast), such as calcium channel blockers (verapamil, diltiazem) or beta-blockers. […] MAT can be controlled if the condition that causes the rapid heartbeat is treated and controlled.

• #1 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  Emergency department care for MAT involves simultaneous assessment and treatment. […] Antiarrhythmics are usually not indicated for treatment of MAT, and specific antiarrhythmic therapy historically has not demonstrated great efficacy in this setting. […] Catheter ablation can cure macroreentrant and focal forms of atrial tachycardia and has become a widely used treatment option for symptomatic, medically refractory cases. […] For patients with complex congenital heart disease, surgical ablation may occasionally be useful. However, this procedure has generally been supplanted by catheter-based ablation. […] Consultation with a cardiac electrophysiologist or cardiologist is recommended for all patients with atrial tachycardia and for patients in whom structural heart disease has been diagnosed or is being considered.

• #1

  https://journals.lww.com/ccmjournal/abstract/1987/01000/treatment_of_multifocal_atrial_tachycardia_with.4.aspx

  We used metoprolol orally or iv in 25 patients with multifocal atrial tachycardia that was complicating severe cardiopulmonary illness, and we observed its effect on heart rate and rhythm, BP, and arterial blood gases. […] We conclude that metoprolol is effective in the management of multifocal atrial tachycardia.

• #1 Atrial Tachycardia Guidelines: Guidelines Summary, 2019 ESC/AEPC Guidelines for the Management of Supraventricular Tachycardia, 2017 EHRA Consensus Document on the Management of Supraventricular Arrhythmias

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

  In August 2019, the European Society of Cardiology (ESC) in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC) released recommendations on the management of supraventricular tachycardia. […] These guidelines include specific recommendations for both acute and ongoing management of atrial tachycardia. […] For conversion of atrial flutter: Intravenous (IV) ibutilide, or IV or oral (PO) (in-hospital) dofetilide. […] For tachycardia responsible for tachycardiomyopathy that cannot be ablated or controlled by drugs: Atrioventricular nodal ablation followed by pacing (ablate and pace) (biventricular or His-bundle pacing). […] Catheter ablation is preferred treatment. (Class I; LOE: B-NR). […] The guidelines emphasize that the first-line treatment is management of the underlying condition. […] For acute treatment in patients with MAT, IV metoprolol or verapamil were recommended; for ongoing management of recurrent symptomatic MAT, oral verapamil (class IIa; LOE: B-NR), metoprolol, or diltiazem may be used.

• #1 Atrial Tachycardias and Atypical Atrial Flutters: Mechanisms and Approaches to Ablation | AER Journal

  https://www.aerjournal.com/articles/atrial-tachycardias-and-atypical-atrial-flutters-mechanisms-and-approaches-ablation?language_content_entity=en

  Ablation can be accomplished with radiofrequency (RF) energy using solid 4-mm electrodes, irrigated RF or large tip electrodes. […] Successful ablation of ATs that demonstrate early RA activation near the His bundle require an understanding of the septal anatomy and the relationship among the tricuspid annulus, mitral annulus and aortic root. […] Macro-reentrant ATs other than typical CTI-dependent atrial flutter often occur in patients with atrial disease, such as those with cardiomyopathies, prior atrial ablation or prior cardiac surgery. […] Macro-reentrant ATs are ablated with linear lesions between unexcitable barriers including scar and anatomical structures. […] Regardless of the location of macroreentry or the length of the ablative lesion, bidirectional conduction block is an important endpoint for ablation.

• #1 Atrial Tachycardia

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

  Therapy for patients suffering from atrial tachycardia depends on the frequency and severity of symptoms. Your physician may decide to implement therapy with oral medications if you are having frequent episodes that affect your daily living. Therapy for AT has three components: Control of the ventricular rate (heart rate), Maintenance of sinus rhythm during asymptomatic periods (suppression of AT), Cardioversion to normal sinus rhythm during symptomatic AT episodes. This can be achieved with either: Medical management, Curative catheter ablation. Medications used to control the ventricular rate during AT episodes include b-blockers, calcium channel blockers, and less commonly digoxin. These medications can be administered orally on a routine outpatient basis, or via intravenous route if necessary in the emergency room. These medications may also have an influence on suppressing AT episodes, with a clear decrease in the frequency and severity of symptoms. Attempts to maintain sinus rhythm can be approached with antiarrhythmic drug therapy if the previously mentioned medications fail to alleviate symptoms. Many patients will ultimately require treatment with antiarrhythmic drugs for termination and suppression of their atrial tachycardia. For those patients who elect to forgo medication either due to intolerable symptoms or side effects from their medications, recurrent symptoms and episodes despite medical therapy, or lack of desire to take daily medications for an extended period of time, your physician may recommend you undergo an electrophysiology study (EPS) and possible curative catheter ablation. The long-term success rate does depend on the location of the AT, with a response of 85-90% common.

• #1 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. […] Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients. […] With the advent of radiofrequency (RF) ablation this type of tachycardia can be treated with high long-term success. […] 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. […] Successful ablation is often marked by acceleration of the AT during RF application prior to termination. […] 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. […] RF ablation is a highly effective strategy for treatment of focal AT arising from LAA.

• #1 ESC Guidelines for Management of Supraventricular Tachycardia: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

  In all re-entrant and most focal arrhythmias, catheter ablation should be offered as an initial choice to patients, after having explained in detail the potential risks and benefits. In post-AF ablation ATs, focal or macrore-entrant, ablation should be deferred for 3 months after AF ablation, when possible. […] Catheter ablation is recommended in asymptomatic patients in whom electrophysiology testing with the use of isoprenaline identifies high-risk properties, such as shortest pre-excited RR interval during AF 250 ms, accessory pathway effective refractory period. […] Sotalol, propranolol, quinidine, and procainamide are no longer used in the updated guidelines for SVT management in pregnant women. During the first trimester, it is recommended that all antiarrhythmic drugs are avoided. Beta-1 selective blockers (except atenolol) or verapamil should be considered for prevention of SVT in patients without Wolff-Parkinson-White (WPW) syndrome (Class IIa). Flecainide or propafenone should be considered for prevention of SVT in patients with WPW syndrome and without ischemic or structural heart disease (Class IIa).

• #1 ESC Guidelines for Management of Supraventricular Tachycardia: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

  This is the first guideline update for SVT by ESC in 16 years. Amiodarone and digoxin are no longer mentioned in the new guidelines for the acute management of narrow complex tachycardia. Sotalol and lidocaine have been removed from the acute management of wide complex tachycardia algorithm. […] Procainamide, sotalol, and digoxin are no longer recommended for the acute management of focal atrial tachycardia (AT). Amiodarone, sotalol, and disopyramide are not recommended for chronic suppression of focal AT. Catheter ablation is recommended for recurrent focal AT, especially if incessant or causing tachycardia cardiomyopathy. Beta-blockers should be considered for recurrent focal AT or atrial flutter, if ablation is not possible or successful. […] For multifocal AT, treatment of an underlying condition is recommended as a first step (Class I). Verapamil, diltiazem, or a selective beta-blocker should be considered (Class IIa). Atrioventricular (AV) nodal ablation followed by biventricular or His-bundle pacing should be considered for patients with left ventricular dysfunction due to recurrent multifocal AT refractory to drug therapy (Class IIa).

• #1 Atrial tachycardia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/atrial-tachycardia

  Pacemaker. A pacemaker is a small device that’s placed in the chest to help control the heartbeat. When it finds an irregular heartbeat, it sends an electrical signal that helps correct the heart’s rhythm. A pacemaker may be needed if other treatments for atrial tachycardia don’t work. For people with atrial tachycardia, a pacemaker is typically placed during with a treatment called AV node ablation.

• #1 Atrial Tachycardia | Conditions | UCSF Health

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

  A technique pioneered at UCSF, radiofrequency catheter ablation destroys or disrupts parts of the electrical pathways causing the arrhythmias, providing relief for patients who may not have responded well to medications, or who would rather not or can’t take medications. […] Internal cardioversion for conversion of atrial fibrillation and atrial flutter to a normal sinus rhythm was developed here at UCSF Medical Center in 1991. […] An implantable cardioverter defibrillator is a device for people who are prone to life-threatening rapid heart rhythms. […] The U.S. Food and Drug Administration (FDA) recently approved the first of a new type of pacemaker that paces both ventricles of the heart to coordinate their contractions and improve their pumping ability. […] The minimally invasive technique has become the treatment of choice for arrhythmia patients who do not respond well to medication.

• #1 Tachycardia: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/tachycardia/treatment

  Implantable cardioverter defibrillator (ICD) – A battery-powered device that can help keep track of your heart rate. […] Cardioversion – A procedure used to treat tachycardia to restore an irregular heartbeat to a normal rhythm. Typically, cardioversion patches are placed on the chest and back to deliver short, electrical impulses to reset the heart to a regular rhythm. […] Chemical (pharmacological) cardioversion – Oral or IV medication can be given to regulate the hearts rhythm without using electric shocks. The rhythmic correction may take longer than with electric cardioversion treatments. […] Other arrhythmia medications may be prescribed long-term as tachycardia treatments or intravenously in an emergency. These include amiodarone, flecainide, and others. […] You can prevent and potentially treat tachycardia by taking care of your heart and avoiding behaviors that trigger a rapid heartbeat. Heart-healthy choices to help maintain a normal heart rhythm include: Maintaining a healthy diet, Quitting smoking, Limiting alcohol, Managing stress levels, Losing excess weight, Exercising regularly, Controlling high cholesterol and high blood pressure with recommended medication from your doctor.

• #1 Surgical treatment of atrial tachycardia arising from left atrial appendage – International Journal of the Cardiovascular Academy

  https://ijcva.org/articles/surgical-treatment-of-atrial-tachycardia-arising-from-left-atrial-appendage/doi/IJCA.IJCA_28_20

  Focal atrial tachycardia arising from the left atrial appendage (LAA) is less frequently encountered in clinical practice. Catheter ablation of this focal tachycardia is the main treatment and has a high success rate. Surgical radiofrequency isolation plus external closure of the appendage is an option in patients’ refractory to catheter methods. […] Surgical ablation methods are valid and successful options in patients who are refractory to medical and catheter methods. Dedicated arrhythmia teams (cardiologists, electrophysiologists, and cardiac surgeons) have the potential to increase patients’ outcomes. […] Surgical ablation, which provides a significant clinical and echocardiographic improvement in patients after failed percutaneous ablation, should be kept in mind as an easily applicable and fast effective option.

• #1 Atrial Tachycardia: Symptoms, Causes & Treatment

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

  Atrial tachycardia is a type of abnormal heart rhythm thats too fast. […] Medication or procedures can control or often cure atrial tachycardia. […] This condition has several possible causes, but usually isnt dangerous. Its often curable or manageable with medication. […] Depending on the type, atrial tachycardia is often curable. When a chronic disease is the cause, treating that disease can often make atrial tachycardia stop. […] Focal atrial tachycardia: This type has a very high cure rate, especially with catheter-based techniques. […] Multifocal atrial tachycardia: This is harder to cure because the problems start at different points in your heart. However, treating other diseases that cause it can resolve multifocal atrial tachycardia. […] Micro-reentrant atrial tachycardia: Its often possible to cure this using catheter-based techniques. In rarer cases, you may need a surgical approach.

• #1 Paroxysmal Atrial Tachycardia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26695

  For a hemodynamically stable patient, according to the same guidelines as above, first line management is IV beta-blockers, IV Diltiazem or IV Verapamil. IV amiodarone or IV ibutilide can be used if the IV beta blockers or IV diltiazem/verapamil are ineffective. […] In chronic management of atrial tachycardia beta blockers, diltiazem and verapamil can be used in their oral forms. In patients without structural heart defects or ischemic heart disease, flecainide or propafenone can be used. Patients can be managed on amiodarone or sotalol. Digitalis is another option for patients with chronic atrial tachycardia. […] Cardioversion can also be used for patients who have refractory atrial tachycardia or atrial tachycardia which has been difficult or unable to control pharmacologically. Another non-pharmacologic treatment used in refractory cases is treatment by radiofrequency catheter ablation. After mapping, the atrial tachycardias origin can be targeted. The ablation technique is aimed at correcting the arrhythmia and curing the condition. Experienced centers have noted success rates 90% with complication rates around 1%.

• #1 Atrial Tachycardias and Atypical Atrial Flutters: Mechanisms and Approaches to Ablation | AER Journal

  https://www.aerjournal.com/articles/atrial-tachycardias-and-atypical-atrial-flutters-mechanisms-and-approaches-ablation?language_content_entity=en

  Effective ablation of microreentrant ATs usually occurs at sites with highly fractionated, low-amplitude electrograms. […] Outcomes after ablation of ATs vary widely depending on the mechanism of arrhythmia, the degree of atrial myopathy and coexisting arrhythmias such as AF. […] High-resolution mapping, in addition to entrainment responses, define the mechanisms of AT and identify sites of origin and critical isthmuses that are targets for ablation.

• #1 Atrial Tachycardia: Symptoms, Causes, Treatment

  https://www.healthline.com/health/atrial-tachycardia

  If a doctor doesn’t think that atrial tachycardia will cause you any health challenges in the future, and if the condition isn’t causing any symptoms, they may recommend regular monitoring alone. […] Doctors may also recommend lifestyle changes for atrial tachycardia, including reducing your caffeine intake, managing your stress, improving your diet by limiting processed foods, and lowering your alcohol intake. […] If your condition does need treatment, a doctor may recommend medications to slow your heart rate, such as calcium channel blockers or beta-blockers. […] If medications aren’t effective or are unlikely to be effective, you may need a type of surgery called cardiac ablation. This procedure involves a specialist inserting a thin, flexible tube through a blood vessel until it reaches your heart.

• #1 ESC Guidelines for Management of Supraventricular Tachycardia: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

  In ACHD, anticoagulation for focal AT or atrial flutter should be similar to that for patients with AF. Catheter ablation in experienced centers should be considered. Sotalol is not recommended as a first-line antiarrhythmic drug due to an increased risk of proarrhythmia and mortality (Class III). Flecainide and propafenone should be avoided in patients with left bundle branch block, or ischemic or structural heart disease (Class III).

• #1 Atrial Tachycardia – Pediatric Cardiology Associates of Houston

  https://kidsheartshouston.com/answers/21853-atrial-tachycardia

  Atrial tachycardia can develop in both babies as well as older children. In babies it tends to spontaneously resolve, often by 8-12 months of age, and sometimes much sooner. Treatment with medication is often necessary to suppress the abnormal tissue and allow the normal sinus node to take over. In some instances, it may be impossible to completely suppress the abnormal tissue and the goal becomes simply to keep the heart rate relatively slow to prevent the heart muscle from tiring out. […] In older children, atrial tachycardia often does not spontaneously resolve. In this situation, treatment with medication is often effective, but many may opt for a more definitive procedure, a radiofrequency ablation. In this procedure, the abnormal focus of tissue is ablated, or destroyed with high frequency energy. This often cures the individual of the problem permanently. […] In summary, atrial tachycardia in children is relatively uncommon. Fortunately most episodes can be treated effectively with either medication or a definitive procedure.

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

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html/1000

  Catheter ablation is an effective first-line treatment option for many patients with AVRT or AVNRT. […] Catheter ablation is the standard of care for older children with symptomatic SVT, although pharmacologic therapy remains the treatment of choice for newborns and infants. […] Patients with Wolff-Parkinson-White syndrome cannot receive nodal-blocking medications in the long-term because of the risk of ventricular fibrillation; therefore, symptomatic patients should receive catheter ablation.

• #1 Resolution of a therapy-resistant focal atrial tachycardia after omega-3 fatty acid supplementation | Cardiology in the Young | Cambridge Core

  https://www.cambridge.org/core/journals/cardiology-in-the-young/article/resolution-of-a-therapyresistant-focal-atrial-tachycardia-after-omega3-fatty-acid-supplementation/EDD420EB45EB73A444FB47BF90FD5D12

  We report on a 14-year-old boy with focal atrial tachycardia. After failure of catheter ablation and medical therapy he received 2 g omega-3 fatty acid supplementation while waiting on repeat ablation. Focal atrial tachycardia disappeared 4 weeks later and antiarrhythmic therapy was terminated. […] We discuss the antiarrhythmic effect of omega 3-fatty acids on the autonomous nervous system based upon six 24-hour Holter electrocardiographs.

• #1 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. […] Initial therapy should be guided by cause, comorbid conditions, haemodynamic status, and patient preference. First-line options for hemodynamically stable patients include intravenous beta-blockers or calcium-channel blockers, or catheter ablation. […] For sustained focal atrial tachycardia, cardiology consultation, class Ic or III anti-arrhythmic agents, and ablative therapy are appropriate.

• #1 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. […] Initial therapy should be guided by cause, comorbid conditions, hemodynamic status, and patient preference. First-line options for hemodynamically stable patients include intravenous beta-blockers or calcium-channel blockers, or catheter ablation. […] For sustained focal atrial tachycardia, cardiology consultation, class Ic or III antiarrhythmic agents, and ablative therapy are appropriate.

• #2 Atrial Tachycardia: Symptoms, Causes & Treatment

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

  Atrial tachycardia is a type of abnormal heart rhythm thats too fast. […] Medication or procedures can control or often cure atrial tachycardia. […] This condition has several possible causes, but usually isnt dangerous. Its often curable or manageable with medication. […] Depending on the type, atrial tachycardia is often curable. When a chronic disease is the cause, treating that disease can often make atrial tachycardia stop. […] Focal atrial tachycardia: This type has a very high cure rate, especially with catheter-based techniques. […] Multifocal atrial tachycardia: This is harder to cure because the problems start at different points in your heart. However, treating other diseases that cause it can resolve multifocal atrial tachycardia. […] Micro-reentrant atrial tachycardia: Its often possible to cure this using catheter-based techniques. In rarer cases, you may need a surgical approach.

• #2 Atrial tachycardia – Wikipedia

  https://en.wikipedia.org/wiki/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. The ventricular rate is controllable with the use of beta blockers or calcium channel blockers. If atrial tachyarrhythmia persists and the patient is symptomatic, the patient may benefit from class IA, IC, or class III antiarrhythmics. Catheter ablation of focal atrial tachycardia may be appropriate in patients failing medical therapy.

• #2 Atrial tachycardias – AF-ABLATION

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

  What is the therapy for atrial tachycardias? […] Vagal manoeuvres are the first choice treatment in hemodynamically stable patients. The Valsalva manoeuvre, the carotid sinus massage, and acupressure of the eyeballs, causing a slowing of the conduction are potentially effective in interrupting the arrhythmia: these interventions are generally less effective than in NRT or AVRT. […] When vagal manoeuvres are ineffective, pharmacological conversion may be attempted, with class 1c or class 3 antiarrhythmic drugs. On the other hand, adenosine in bolus i.v. is basically ineffective in atrial tachycardia and sinus re-entry tachycardia. Beta-blocker drugs, such as metoprolol or esmolol, can also be tried and are effective, in particular, in tachycardia due to increased automatism. […] The external electrical cardioversion is instead used in case of compromise of the hemodynamic state, when the patient is hypotensive, is in pulmonary edema, or experiences chest pain. 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. […] RF ablation should be considered in all patients refractory to medical therapy or in those in whom antiarrhythmics are contraindicated.

• #2 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  The primary treatment during an episode of atrial tachycardia is considered to be rate control using atrioventricular (AV) nodal blocking agents (eg, beta-blockers or calcium channel blockers). […] In the setting of hemodynamic compromise due to SVT or known atrial tachycardia in which a drug may be therapeutic, the ultra short-acting agent adenosine or the short-acting beta-blocker esmolol may be tried. […] Atrial tachycardia often self-terminates and may be nonsustained if the cause is addressed. […] In patients with documented systolic dysfunction and symptoms of heart failure, elimination of the tachycardia by ablation can afford reversal of systolic dysfunction and resolution of heart failure symptoms. […] For any patient who does not tolerate the rhythm well hemodynamically and in whom rate control drugs are ineffective or contraindicated, cardioversion should be considered.

• #2 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  Atrial tachycardia from triggered activity (most frequently found in the setting of digitalis toxicity) is sensitive to verapamil, beta-blockers, and adenosine. […] For refractory recurrent atrial tachycardias causing symptoms (particularly recurrence after electrical cardioversion), antiarrhythmic drugs have been tried. […] Class III antiarrhythmic drugs such as amiodarone, sotalol, dronedarone, and dofetilide have variable efficacy in terminating atrial tachycardia. […] Atrial tachycardia due to digitalis intoxication often manifests as AV conduction block, ventricular arrhythmias, or both. […] In patients with multifocal atrial tachycardia (MAT), treatment and/or reversal of the precipitating cause may be the only therapy that is required; however, the arrhythmia may recur if the underlying condition worsens.

• #2 Paroxysmal Atrial Tachycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538317/

  Atrial tachycardia is a form of supraventricular tachycardia (SVT) usually seen in patients with structural heart abnormalities but also seen in patients with structurally normal hearts. […] This activity illustrates the evaluation and treatment of atrial tachycardia and reviews the role of the interprofessional team in managing those with this condition. […] Explain how atrial tachycardia is managed. […] According to the 2015 American College of Cardiology, American Heart Association and the Heart Rhythm Society, first line management for hemodynamically unstable atrial tachycardia is IV Adenosine. […] If Adenosine is ineffective or not possible (due to no IV access for example), synchronized cardioversion is warranted. […] For a hemodynamically stable patient, according to the same guidelines as above, first line management is IV beta-blockers, IV Diltiazem or IV Verapamil.

• #2 Atrial Tachycardia – StatPearls – NCBI Bookshelf

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

  Atrial tachycardia is an arrhythmia with electrical impulses originating within the atria. […] Atrial tachycardia can be a result of one or a combination of the mechanisms leading to arrhythmia: automatic, triggered activity, or reentry. […] The focus of this activity will be on focal atrial tachycardia (FAT). […] 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. […] The ventricular rate is controllable with the use of beta blockers or calcium channel blockers. […] If atrial tachyarrhythmia persists and the patient is symptomatic, the patient may benefit from class IA, IC, or class III antiarrhythmics.

• #2 Atrial Tachycardia – StatPearls – NCBI Bookshelf

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

  Catheter ablation of focal atrial tachycardia may be appropriate in patients failing medical therapy. […] Ventricular rate control is achievable with calcium channel or beta blockers. […] If the patient remains persistently tachycardic or has uncontrolled symptoms, the patient may benefit from antiarrhythmic therapy with class IC or III antiarrhythmics.

• #2 Paroxysmal Atrial Tachycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538317/

  IV amiodarone or IV ibutilide can be used if the IV beta blockers or IV diltiazem/verapamil are ineffective. […] In chronic management of atrial tachycardia beta blockers, diltiazem and verapamil can be used in their oral forms. […] Cardioversion can also be used for patients who have refractory atrial tachycardia or atrial tachycardia which has been difficult or unable to control pharmacologically. […] Another non-pharmacologic treatment used in refractory cases is treatment by radiofrequency catheter ablation. […] After mapping, the atrial tachycardias origin can be targeted. The ablation technique is aimed at correcting the arrhythmia and curing the condition.

• #2 Multifocal atrial tachycardia – Wikipedia

  https://en.wikipedia.org/wiki/Multifocal_atrial_tachycardia

  Management of multifocal atrial tachycardia consists mainly of the treatment of the underlying cause. If treatment is indicated, therapy should begin with first correcting underlying electrolyte abnormalities with the repletion of potassium to maintain greater than 4 mEq/L and magnesium greater than 2 mEq/L. Studies have shown magnesium suppresses ectopic atrial activity and can be beneficial even if magnesium levels are within the normal range. […] Once electrolyte abnormalities have been corrected, possible treatment options include non-dihydropyridine calcium channel blockers, beta-blockers, and atrioventricular (AV) node ablation. Studies have found no role for antiarrhythmic agents, cardioversion, or anticoagulation. In the absence of underlying pulmonary disease, the first-line agent is beta-blockers. A beta-blockers act to suppress ectopic foci by reducing sympathetic stimulation and decreasing conduction through the atrioventricular node, thereby slowing the ventricular response.

• #2 Atrial tachycardia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/atrial-tachycardia

  Treatment of atrial tachycardia depends on what causes it and how severe it is. Treatment may include: […] Vagal maneuvers. Simple but specific actions such as coughing, putting an ice pack on the face or pushing down as if having a bowel movement can help slow down the heart rate. These actions affect the vagus nerve, which helps control the heartbeat. […] Medicines. Medicines may be given to control the heart rate and reset the heart rhythm. Some medicines may need to be given by IV. […] Cardioversion. Paddles or patches on the chest are used to give an electrical shock to the heart. The quick, low-energy shock resets the heart’s rhythm. This may be a treatment option if atrial tachycardia doesn’t get better with vagal maneuvers or medicine. […] Catheter ablation. A doctor guides a thin, flexible tube called a catheter through a blood vessel, usually in the groin, and up to the heart. Sometimes more than one catheter is used. Sensors on the tip of the catheter use heat energy, called radiofrequency energy, to create tiny scars in the heart. The scar tissue blocks faulty electrical signals. This restores a regular heartbeat.

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

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

  Radiofrequency catheter ablation (RFA) is a technique to treat arrhythmia that was pioneered at UCSF Medical Center. It disrupts part of the electrical pathway causing irregular heart rhythms, providing relief for patients who may not respond well to medications, who prefer not to take medications or who can’t take medications. […] RFA has been proven very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide the best option for you or your child. […] Cryoablation, sometimes referred to as cryo, is similar to radiofrequency catheter ablation (RFA) in that it is a procedure that disrupts the abnormal electrical pathway in the heart. Instead of burning cells, however, cryoablation destroys cells by freezing them. […] Cryoablation has been very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide which method is the best option.

• #2 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. […] Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients. […] With the advent of radiofrequency (RF) ablation this type of tachycardia can be treated with high long-term success. […] 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. […] Successful ablation is often marked by acceleration of the AT during RF application prior to termination. […] 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. […] RF ablation is a highly effective strategy for treatment of focal AT arising from LAA.

• #2 Atrial Tachycardias and Atypical Atrial Flutters: Mechanisms and Approaches to Ablation | AER Journal

  https://www.aerjournal.com/articles/atrial-tachycardias-and-atypical-atrial-flutters-mechanisms-and-approaches-ablation?language_content_entity=en

  Effective ablation of microreentrant ATs usually occurs at sites with highly fractionated, low-amplitude electrograms. […] Outcomes after ablation of ATs vary widely depending on the mechanism of arrhythmia, the degree of atrial myopathy and coexisting arrhythmias such as AF. […] High-resolution mapping, in addition to entrainment responses, define the mechanisms of AT and identify sites of origin and critical isthmuses that are targets for ablation.

• #2 Atrial tachycardia | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/atrial-tachycardia

  Pacemaker. A pacemaker is a small device that’s placed in the chest to help control the heartbeat. When it finds an irregular heartbeat, it sends an electrical signal that helps correct the heart’s rhythm. A pacemaker may be needed if other treatments for atrial tachycardia don’t work. For people with atrial tachycardia, a pacemaker is typically placed during with a treatment called AV node ablation.

• #2 Atrial Tachycardia: Symptoms, Causes & Treatment

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

  Medications that providers often use to treat atrial tachycardia include: Beta-blockers: This type of medication can stop or slow down certain cell functions, especially in your heart. […] Calcium channel blockers: These change the way your heart muscle cells use calcium. This can reduce how sensitive your heart muscle cells are to an electrical signal. […] Ablation is another common atrial tachycardia treatment. Ablation treats certain areas of your heart to stop them from improperly conducting electricity. […] Catheter ablation: Your provider inserts a device into a major blood vessel (usually near your groin). Then, they thread it up to your heart to treat the problem area. […] Surgical ablation: If your provider cant fix your issue with catheter ablation, they may do surgery. Surgical approaches use similar methods but access the heart through an incision in your chest.

• #2 Atrial Tachycardia: Diagnosis and Treatment – Dermatology Advisor

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

  Treatment through catheter based ablation is the preferred approach given its high success rate and potential freedom of arrhythmias without the need for continued drug therapy. The catheter ablation procedure is a percutaneous invasive intervention that requires vascular access through the femoral and sometimes subclavian veins. […] With the use of pacing maneuvers and pharmacologic interventions, the tachycardia can be induced (if not present at the time of the procedure) and characterized establishing a definitive diagnosis of atrial tachycardia and differentiating between focal and macro-reentrant. […] The procedure may require access to the left atrium performing a transseptal puncture or retrograde through the aorta. The contemporary approach to catheter-based ablation using nonfluoroscopic mapping systems, intracardiac echocardiography, and irrigated tip catheters allows for improved safety during the procedure. Success rate is close to 90% and recurrence rates are low.

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

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

  If a person is at low risk, with no underlying heart disease, and the symptoms rarely occur or are not causing an issue, a doctor may recommend monitoring the condition, or watching and waiting. […] Treatment first focuses on managing underlying causes if a doctor identifies any. For example, a person may need to reduce caffeine, better manage stress, or treat underlying heart disease. […] A cardiologist may also prescribe medications such as calcium channel blockers and beta-blockers. These medications slow the heart rate, which can keep a person from having an atrial tachycardia episode. […] If the condition does not respond to treatment with medication, a healthcare professional may recommend a type of cardiac ablation surgery called catheter ablation. […] During this surgery, an electrophysiologist inserts a thin, flexible tube through a blood vessel to the heart. They then use radiofrequency energy to destroy the tissue from which the irregular heart rhythm originates. […] They can also perform cryoablation, which uses cold temperatures to scar the tissue that is causing the irregular heart rate.

• #2 Atrial Tachycardias After “Multiple” Previous Ablations for Tachyarrhythmias: Treatment by Anti-arrhythmic Drugs or Additional Ablation?

  https://www.innovationsincrm.com/cardiac-rhythm-management/articles-2024/march/2195-atrial-tachycardias-after-multiple-previous-ablations-for-tachyarrhythmias

  The patient requested another CA procedure, which was performed using high-density mapping that accurately identified arrhythmia mechanisms, elucidated the disease substrate, and restored the sinus rhythm successfully, resulting in marked clinical improvement upon maintaining the sinus rhythm long term. […] The patients eighth CA procedure was performed under general anesthesia, with the CARTO 3 mapping system (version 7.2) (Biosense Webster). […] The mapping catheter was then exchanged for a THERMOCOOL SMARTTOUCH ablation catheter (Biosense Webster). […] RF ablation was performed by delivering RF energy at 35 W, maintaining a contact force of 10-15 g at the discontinuous segment of the previous ablation line. […] Our case report also brings in the discussion on rhythm-control over rate-control treatment strategies in patients with AF.

• #2 Successful treatment of the focal ectopic atrial tachycardia in an infant with a single dose of ivabradin | Cardiology in the Young | Cambridge Core

  https://www.cambridge.org/core/journals/cardiology-in-the-young/article/successful-treatment-of-the-focal-ectopic-atrial-tachycardia-in-an-infant-with-a-single-dose-of-ivabradin/14C18F6CA5088AB0ED31B4197068BF78

  We report on a 12-month-old boy with an ectopic atrial tachycardia successfully treated with the ivabradine that acts on cardiac pacemaker cells by selectively inhibiting the If channel. […] Sinus rhythm was restored 2 hours after ivabradine treatment was started.

• #3 Atrial Tachycardia Treatment & Management: Approach Considerations, Cardioversion, Pharmacologic Treatment

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

  The primary treatment during an episode of atrial tachycardia is considered to be rate control using atrioventricular (AV) nodal blocking agents (eg, beta-blockers or calcium channel blockers). […] In the setting of hemodynamic compromise due to SVT or known atrial tachycardia in which a drug may be therapeutic, the ultra short-acting agent adenosine or the short-acting beta-blocker esmolol may be tried. […] Atrial tachycardia often self-terminates and may be nonsustained if the cause is addressed. […] In patients with documented systolic dysfunction and symptoms of heart failure, elimination of the tachycardia by ablation can afford reversal of systolic dysfunction and resolution of heart failure symptoms. […] For any patient who does not tolerate the rhythm well hemodynamically and in whom rate control drugs are ineffective or contraindicated, cardioversion should be considered.

• #3 Tachycardia: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/tachycardia/treatment

  Implantable cardioverter defibrillator (ICD) – A battery-powered device that can help keep track of your heart rate. […] Cardioversion – A procedure used to treat tachycardia to restore an irregular heartbeat to a normal rhythm. Typically, cardioversion patches are placed on the chest and back to deliver short, electrical impulses to reset the heart to a regular rhythm. […] Chemical (pharmacological) cardioversion – Oral or IV medication can be given to regulate the hearts rhythm without using electric shocks. The rhythmic correction may take longer than with electric cardioversion treatments. […] Other arrhythmia medications may be prescribed long-term as tachycardia treatments or intravenously in an emergency. These include amiodarone, flecainide, and others. […] You can prevent and potentially treat tachycardia by taking care of your heart and avoiding behaviors that trigger a rapid heartbeat. Heart-healthy choices to help maintain a normal heart rhythm include: Maintaining a healthy diet, Quitting smoking, Limiting alcohol, Managing stress levels, Losing excess weight, Exercising regularly, Controlling high cholesterol and high blood pressure with recommended medication from your doctor.

• #3 Atrial Tachycardia: Symptoms, Causes & Treatment

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

  Medications that providers often use to treat atrial tachycardia include: Beta-blockers: This type of medication can stop or slow down certain cell functions, especially in your heart. […] Calcium channel blockers: These change the way your heart muscle cells use calcium. This can reduce how sensitive your heart muscle cells are to an electrical signal. […] Ablation is another common atrial tachycardia treatment. Ablation treats certain areas of your heart to stop them from improperly conducting electricity. […] Catheter ablation: Your provider inserts a device into a major blood vessel (usually near your groin). Then, they thread it up to your heart to treat the problem area. […] Surgical ablation: If your provider cant fix your issue with catheter ablation, they may do surgery. Surgical approaches use similar methods but access the heart through an incision in your chest.

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