Focal Atrial Tachycardia (AT)

Management

Initial management of focal atrial tachycardia should focus on addressing underlying causes: treating acute illness, cessation of stimulants, stress reduction. The ventricular rate is controllable with the use of beta blockers or calcium channel blockers. If atrial tachyarrhythmia persists and the patient is symptomatic, the patient may benefit from class IA, IC, or class III antiarrhythmics. These medications need to be used cautiously in selective patients.

Focal atrial tachycardia can be completely cured with catheter ablation in over 95% of the cases. Focal atrial tachycardia often occurs as a result of abnormal automaticity and are challenging to initiate during an electrophysiology study and require drug infusion to induce. As the driver of many focal atrial tachycardias is by enhanced automaticity, electrical cardioversion without concurrent medical therapy as listed previously will likely result in arrhythmia recurrence.