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Atrial tachycardia

Atrial tachycardia is a fast heartbeat (arrhythmia). It's a type of supraventricular tachycardia (SVT).

During an atrial tachycardia episode, the heart rate increases to more than 100 beats a minute before returning to a typical heart rate of around 60 to 80 beats a minute. An episode may start gradually or it may start abruptly. Atrial tachycardia can cause a feeling of a pounding or racing heartbeat, light-headedness, dizziness, and fainting.

Atrial tachycardia is quite common. It may occur in people who have had heart surgery or who are pregnant. It can be triggered by infections, stimulant medications or alcohol.

Diagnosis

Tests and procedures used to diagnose atrial tachycardia may include:

  • Blood tests to check for thyroid disorders, heart disease or other conditions linked to atrial tachycardia
  • Electrocardiogram (ECG or EKG) to measure the electrical activity of the heart and measure the timing and duration of each heartbeat
  • Holter monitor, a portable ECG device that is worn for a day or more to record the heart's rate and rhythm during daily activities
  • Echocardiogram, which uses sound waves to produce images of the heart's size, structure and motion

A health care provider might try to trigger an episode of atrial tachycardia with other tests, which may include:

  • Stress test, which monitors heart activity while exercising on a treadmill or stationary bike
  • Electrophysiological (EP) study and cardiac mapping, which allows the health care provider to see how electrical signals spread through the heart during each heartbeat

Treatment

Treatment of atrial tachycardia depends on the severity of the condition and its triggers. Your health care provider may recommend:

  • Vagal maneuvers. Simple but specific actions such as coughing, putting an ice pack on the face or bearing down as if having a bowel movement can help slow down the heart rate. Your health care provider may ask you to do these actions during an episode of atrial tachycardia. These actions affect the vagus nerve, which helps control the heartbeat.
  • Medications. Medications may be prescribed to control the heart rate and restore the heart rhythm. Medications may need to be given by IV.
  • Cardioversion. In this procedure, a shock is delivered to the heart through paddles or patches on the chest. The current affects the electrical signals in the heart and can restore a typical heart rate. This procedure may be done if atrial tachycardia doesn't get better with vagal maneuvers or medication.
  • Catheter ablation. A thin, flexible tube (catheter) is guided 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 (radiofrequency energy) to create tiny scars in the heart. The scar tissue permanently blocks faulty electrical signals, restoring a regular heartbeat.
  • Pacemaker. This small device may be needed if other treatments for atrial tachycardia don't work. It's surgically implanted under the skin in the chest area. When the pacemaker detects an irregular heartbeat, it sends an electrical pulse that helps correct the heart's rhythm. For people with atrial tachycardia, this procedure is typically done with ablation of the AV node.

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