Ver el código de «Atrial tachycardia»

==Background==
*Also known as focal atrial tachycardia, Paroxysmal Atrial Tachycardia (PAT), unifocal atrial tachycardia, ectopic atrial tachycardia
*Rate >100 bpm
*Electrical focus that originates outside in the sinus node at a single location
**By comparison, reentrant tachycardias (eg. [[Paroxysmal supraventricular tachycardia|AVRT, AVNRT]]) involve multiple foci/ larger circuits
*Sustained atrial tachycardia can lead to a tachycardia-induced cardiomyopathy.
*Differs from sinus tachycardia in that the impulses are generated by an ectopic focus somewhere within the atrial myocardium rather than the sinus node. 
*Multifocal atrial tachycardia is similar, but has P waves with at least three different morphologies.
*The combination of atrial tachycardia plus AV block is particularly common in [[digoxin toxicity]].

==Clinical Features==
*Often asymptomatic
*[[Palpitations]]
**Non-specific finding
**Associated with all tachydysrhythmias, not just AT
**Rapid fluttering/throbbing/pounding sensation in the chest or neck
*[[Syncope]]
**Patients with AT rarely present with syncope 
**Cerebral hypoperfusion is more common with a ventricular rate >200 bpm
*[[Chest pain]]
**Can present if there is underlying cardiovascular disease 
**Represents a worsening of the associated disease
*[[Dyspnea]]
**Can present if there is underlying cardiovascular disease 
**Represents a worsening of the associated disease

==Differential Diagnosis==
{{Tachycardia (narrow) DDX}}

==Evaluation==
[[File:PMC3665213 CRIM.MEDICINE2013-430862.002.png|thumb|P waves inverted in lead II and AVL while upright in III and AVF, suggesting ectopic atrial tachycardia, most likely originating from the left side.]]
===Workup===
*[[ECG]]

===Diagnosis===
====ECG Features====
*Atrial rate >100 bpm
*P-waves
**Morphology abnormal (when compared with sinus P wave due to ectopic origin)
**Has at least three consecutive identical ectopic p waves
**Axis frequently abnormal (e.g. inverted in inferior leads)
*QRS complexes 
**Usually normal morphology (unless pre-existing bundle branch block, accessory pathway, or rate related aberrant conduction)
*Baseline isoelectric (unlike atrial flutter)
*[[AV block]] may be present

==Management==
===Unstable===
*[[Cardioversion]]

===Stable===
''Initial treatment may be aimed at rate control, while later resolution of clinical symptoms usually requires restoration of normal sinus rhythm.''
*If [[digoxin toxicity]], stop drug and consider [[Digoxin Immune Fab]]
*[[Beta-blockers]] are first-line, particularly if blood pressure is stable
*Other options include:
**[[Calcium channel blocker]]
**[[Digoxin]]
**[[Amiodarone]]

==Disposition==

==See Also==
*[[Narrow-complex tachycardia]]

==External Links==
*[https://litfl.com/atrial-tachycardia-ecg-library/ LITFL - Focal Atrial Tachycardia (FAT)]

==References==
<references/>
[[Category:Cardiology]]