Atrial Tachycardia

Atrial tachycardia is a type of abnormal heart rhythm (arrhythmia). It makes the upper chambers (atria) of your heart beat faster than normal. They can beat 100 to 250 times per minute. This condition is a type of SVT (supraventricular tachycardia) or fast heartbeat above your ventricles.

Several things can cause atrial tachycardia. But it usually isn’t dangerous. It’s often curable or manageable with medication.

Atrial tachycardia is fairly common. It becomes more common as you get older.

Types of this condition

Atrial tachycardia has two types:

• Reentrant: This type affects a wide area. It usually happens because your heartbeat signal has to travel around a part of your heart or an area of scar tissue.
• Focal: This type starts in a specific place (focus) on your heart. It’s typically not dangerous. But it can be if it keeps going over a longer period.

Some people have a multifocal type. This means they have more than one focus. This type of atrial tachycardia may be harder to treat. This is because the problems start at different points in your heart.

You may hear healthcare providers refer to atrial tachycardia as “ectopic.” This means something isn’t where it should be. In this case, it refers to the signals. You may also hear the term “paroxysmal.” That means a rapid heart rate happens suddenly. This is how a provider might describe your issue.

Symptoms of atrial tachycardia

Atrial tachycardia can happen without symptoms, especially when it happens only for short periods. It’s important to have a provider check out your symptoms early. This is because some of the symptoms also happen with more serious heart problems.

The most common symptom is a fast heart rate. Atrial tachycardia symptoms in adults often include:

• Heart palpitations or feeling your heart beating faster or stronger than usual
• Dizziness and lightheadedness
• Fainting or passing out
• Chest pain (angina)
• Shortness of breath

Infants and children can have these symptoms:

• Vomiting
• Feeding problems
• Rapid breathing

Atrial tachycardia causes

With this issue, the upper chambers of your heart squeeze faster than the lower chambers. A faulty electrical signal or a cell that isn’t working right can cause this. There are three ways that this usually happens:

• Automaticity: Another group of cells or a single cell in your heart can take over for the normal cells that set the pace of your heart rhythm. An imbalance of sodium, potassium or calcium can cause this.
• Triggered activity: Sometimes, a chemical imbalance in heart muscle cells may make them fire when they aren’t supposed to.
• Reentry: Due to a redirection of electricity, cells can form a circuit and transmit this wave of electricity. This leads to abnormal beats. This typically happens after surgery or with scar tissue in your heart.

Risk factors

Atrial tachycardia can happen to anyone who has an issue that can lead to it. Some of these include:

• Heart disease
• Heart attack
• Lung disease
• Electrolyte imbalances
• Too much alcohol intake
• Infection
• Low oxygen levels
• Toxic effects of digoxin (a medication)
• Caffeine and other stimulants

To reduce your risk of atrial tachycardia, you can avoid or limit your use of addictive substances, eat nutritious foods and get regular physical activity.

How is atrial tachycardia diagnosed?

A healthcare provider can diagnose you when you have symptoms of a heart rhythm problem. They’ll use testing to check your heart rhythm.

Providers use these tests to diagnose atrial tachycardia:

• Physical exam: While listening to your heart, your provider may hear a fast heart rhythm.
• Electrocardiogram (ECG or EKG): This test measures your heart’s electrical activity using sensors they attach to your chest.
• Holter monitor: This is like an EKG, but it records heart activity at home over a few days or weeks.
• Ambulatory monitors: These devices work like an EKG. They record your heart’s activity while you wear them for up to 30 days.
• Electrophysiology study: This procedure maps and measures your heart’s electrical activity. It can show areas where this activity in your heart isn’t happening as it should.
• Implantable loop recorder: This small recorder, implanted under your skin in your chest, monitors your heart rhythm for months or years. Your provider might offer this when you have infrequent symptoms that suggest arrhythmia.

Sometimes, a healthcare provider may use an invasive test to detect and/or induce this abnormal rhythm.

How is it treated?

Atrial tachycardia treatment mainly consists of medicines and procedures.

Medications

Medications that providers often use for atrial tachycardia management include:

• Beta-blockers: These can stop or slow down certain cell functions in your heart.
• Calcium channel blockers: These can reduce how sensitive your heart muscle cells are to an electrical signal.
• Other arrhythmia medicines: Depending on what caused the arrhythmia, these types of medicines may help.

Ablation

Ablation treats certain areas of your heart to stop them from conducting electricity the wrong way. Your provider can perform an ablation using these methods:

• Catheter ablation: They put an ablation catheter into a major blood vessel and guide it to your heart. They treat the problem area with heat or extreme cold.
• Surgical ablation: If your provider can’t fix your issue with catheter ablation, they may do surgery. Surgery uses similar methods. But it reaches your heart through a cut in your chest.

Can it be cured?

Depending on the type, atrial tachycardia is often curable. But in some cases, it can return. Or other types of heart rhythm issues may happen.

When a long-term (chronic) disease is the cause, treating that disease can often make atrial tachycardia stop. This may work for multifocal atrial tachycardia, which is harder to cure.

Focal atrial tachycardia has a very high cure rate, especially with catheter ablation. And healthcare providers can often cure the micro-reentrant type, too. They use catheter-based techniques to block part of a faulty electrical circuit.

If you don’t have symptoms and atrial tachycardia only lasts for short periods, your provider may just monitor your condition. Or they may prescribe medicines to control your abnormal heart rhythm.

In some cases, atrial tachycardia can go away on its own. This is more likely if it only happens for short amounts of time.

Recovery time

Most people who have a catheter ablation can go home that same day or the next day. The recovery time for surgery can take longer, possibly a few days.

If you’re taking medicine for this condition, your healthcare provider can tell you when you can expect to start feeling better. They’ll also set up a follow-up visit to see if the medicine is helping or if you need a different dose or type of medicine.

When should I see my healthcare provider for atrial tachycardia?

Follow up with your provider as instructed. These follow-up visits can help track any lingering effects from the condition. They can also spot signs that it’s back.

You should talk to your provider if your symptoms get worse, happen more often or start to disrupt your life.

You should get emergency medical care if you suddenly develop shortness of breath, have chest pain, pass out for an unknown reason or become very dizzy.

You may want to ask your provider:

• What type of atrial tachycardia do I have?
• What’s the best treatment for me?
• How often do I need follow-up visits with you?

What can I expect if I have atrial tachycardia?

For most people, this condition only happens for short periods. It’s not dangerous when it’s short-lived. You shouldn’t have any long-term problems from it. But when it happens for long periods, it can cause problems if you wait too long to get care.

There are many ways to treat atrial tachycardia. Some treatments can cure it. You can also keep it from returning or getting worse. You can do this by avoiding things that cause it, like sleep deprivation, caffeine, alcohol use or other addictive substances.

How long does atrial tachycardia last?

For some people, atrial tachycardia may go away on its own. For others, it may never return after an ablation procedure. The prognosis is good for many people with atrial tachycardia. But there are some cases — especially when another disease is the cause — where it may become a lifelong concern. For them, medication may reduce or control the symptoms.

How can atrial tachycardia be prevented?

Atrial tachycardia is unpredictable and isn’t preventable. But you may be able to reduce your risk of developing it by avoiding triggers. You can also try to prevent or delay getting conditions that can cause atrial tachycardia.

Is atrial tachycardia serious?

When atrial tachycardia only lasts for short periods, healthcare providers don’t consider it dangerous. But when you have atrial tachycardia that lasts or happens a lot, it can cause a problem called cardiomyopathy. This can weaken and damage your heart. Without treatment, cardiomyopathy can lead to heart failure and death.