Focal atrial tachycardia

Abstract

Focal atrial tachycardia is a relatively uncommon arrhythmia. Nevertheless, the management of highly symptomatic patients with focal atrial tachycardia can be problematic owing to the poor response to medical treatment. Moreover, focal atrial tachycardia can trigger other atrial arrhythmias like atrial fibrillation and flutter. Radiofrequency ablation of focal atrial tachycardia is extremely successful and this approach is becoming the preferred treatment for symptomatic patients.In this review, we describe the pathophysiology, anatomical localisation, clinical features, diagnosis and therapeutic options for the management of focal atrial tachycardia.

Radiofrequency ablation of focal atrial tachycardia: Benefit of electroanatomical mapping over conventional mapping

“…2). The distribution of the localizations is congruent with the previously published data (2,6,13,16,24,31).…”

“…Antiarrhythmic treatment of focal atrial tachycardia is usually difficult but catheter ablation has been shown to be effective in its treatment, partially in combination with pharmacological therapy. Radiofrequency catheter ablation is currently the first-line therapy in all symptomatic focal atrial tachycardia cases, especially when cardiac dysfunction develops (4,23,24,30) (Table II).…”

“…Interventional therapy is reported as the best and safest therapy for patients with drug-refractory AT or incessant AT, especially when tachycardia-induced cardiomyopathy has been developed (5,9,23,24,30). Catheter ablation is now accepted as the treatment of choice for this type of tachycardia, the success rate varies between 70 and 100% (1, 3, 10, 13-16, 18, 21, 23, 25, 29, 30).…”

“…No large studies have been conducted to assess the effect of pharmacologic treatment on patients with focal ATs, but both paroxysmal and incessant ATs are reported to be difficult to treat medically (23,24). Interventional therapy is reported as the best and safest therapy for patients with drug-refractory AT or incessant AT, especially when tachycardia-induced cardiomyopathy has been developed (5,9,23,24,30).…”

An unusual focal atrial tachycardia that simulates a common node reentrant tachycardia: A case report

“…[1] It is defined as a regular atrial rhythm that arise outside of the sinus node, from a single site within the left or right atrium, which may be due either by a micro reentry or by the exaltation of the automatism of an ectopic focus and may also result from triggered activity. [2] Although AV conduction is usually 1:1 and the PR interval is often in the normal range producing a long R-P interval, occasionally, especially when the heart rate is particularly high or the AV conduction is markedly increased, [3] a focal AT with a 1:1 AV conduction may have a short RP interval (< 90 ms). In these cases it is necessary to differentiate AT from other SVTs and in particular from the typical AVNRT, that is one of the most common paroxysmal SVTs [1] and that is a regular SVT.…”