Atrial tachycardia
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]
Synonyms and keywords: AT; focal atrial tachycardia; unifocal atrial tachycardia
Overview
Atrial tachycardia is an regular electrical rhythm, usually greater than 100 beats per minute, arising from the atria. Focal atria tachycardia refers to a rhythm originating from a single site either in the left or right atrium. Focal ATs can occur in otherwise normal individuals or in the background of organic heart diseases.
Classification
ATs can be classified based on the pathophysiological mechanisms, anatomy, and the origin of the electrical impulses into two broad categories:
- Focal atrial tachycardia - This is a type of AT that originates from a focal area in the atria. In a study, 63% of ATs originated from the right atrium while 37% were from the left atrium.[1] Sites of origin within the right atrium include: tricuspid annulus, crista terminalis, coronary sinus ostium, perinodal tissues, and right atrium appendage. Sites in the left atrium include: pulmonary veins, mitral annulus, coronary sinus body, left intraatrial septum, and left atrial appendage.
- Reentrant atrial tachycardia - This is commonly seen with individuals with organic heart diseases, including myocardial infarction or complications of cardiac surgery involving incision and scarring to the atrium.
Pathophysiology
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Acute stroke
- Alcohol overdose
- Cocaine overdose
- Digitalis toxicity
- Hypokalemia
- Hypoxia
- Myocardial infarction
- Theophylline toxicity
Common Causes
Causes by Organ System
| Cardiovascular | Cardiomyopathy, myocardial infarction |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Albuterol, caffeine, theophylline |
| Ear Nose Throat | No underlying causes |
| Endocrine | Hyperthyroidism |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | Acute stroke |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | Alcohol, caffeine, cocaine, digitalis, theophylline |
| Psychiatric | No underlying causes |
| Pulmonary | Hypoxia |
| Renal/Electrolyte | Hypokalemia, hypomagnesemia |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
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References
- ↑ Kistler, PM.; Roberts-Thomson, KC.; Haqqani, HM.; Fynn, SP.; Singarayar, S.; Vohra, JK.; Morton, JB.; Sparks, PB.; Kalman, JM. (2006). "P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin". J Am Coll Cardiol. 48 (5): 1010–7. doi:10.1016/j.jacc.2006.03.058. PMID 16949495. Unknown parameter
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