Focal (ectopic) atrial tachycardia

The Difference ◽

Focal atrial tachycardia is an atrial arrhythmia arising in either the left or the right atrium, usually faster than 100 min−1 and regular, with a P-wave morphology that is different from the normal P-wave morphology associated with sinus rhythm—the difference in morphology being more pronounced the further away the focus lies from the sinus node. The ventricular rate is generally fast also, dependent on the nature of the atrioventricular conduction (AV); 1:1 conduction may be seen, especially in younger patients or patients with accessory pathways capable of very rapid antegrade conduction; alternatively, 2:1, Wenckebach-type, or higher-grade AV block may be seen.

Focal Atrial Tachycardia from the Right Superior Pulmonary Vein with Stable P Wave Morphology and Cycle Length: the Problem of Discriminating between a Right and Left Origin

From Signals to Colours ◽

10.1007/978-88-470-0649-2_6 ◽

2008 ◽

pp. 45-55

Keyword(s):

Pulmonary Vein ◽

Cycle Length ◽

Atrial Tachycardia ◽

P Wave ◽

Superior Pulmonary Vein ◽

Wave Morphology ◽

Focal Atrial Tachycardia From the Right Superior Pulmonary Vein with Irregular Cycle and P Wave Morphology: the Missing Link in the Chain Connecting Organized and Disorganized Atrial Arrhythmias?

From Signals to Colours ◽

10.1007/978-88-470-0649-2_5 ◽

2008 ◽

pp. 37-43

Keyword(s):

Pulmonary Vein ◽

Atrial Tachycardia ◽

P Wave ◽

Atrial Arrhythmias ◽

Missing Link ◽

Superior Pulmonary Vein ◽

Wave Morphology ◽

Electrocardiogram Recognition and Ablation of Atrial Tachycardia

Asia Pacific Cardiology ◽

10.15420/apc.2011:3:1:80 ◽

2011 ◽

Vol 3 (1) ◽

pp. 80

Author(s):

Alexander Feldman ◽

Jonathan M Kalman ◽

◽

Keyword(s):

Catheter Ablation ◽

Atrial Tachycardia ◽

Primary Treatment ◽

P Wave ◽

Wave Morphology ◽

Mapping Techniques ◽

Electrocardiogram Ecg ◽

Surface Electrocardiogram

Focal atrial tachycardia (AT) is a relatively uncommon cause of supraventricular tachycardia, but when present is frequently difficult to treat medically. Atrial tachycardias tend to originate from anatomically determined atrial sites. The P-wave morphology on surface electrocardiogram (ECG) together with more sophisticated contemporary mapping techniques facilitates precise localisation and ablation of these ectopic foci. Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients.

Coughing as a potentially effective induction method of atrial tachycardia: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa459 ◽

2020 ◽

Author(s):

Reina Tonegawa-Kuji ◽

Kenichiro Yamagata ◽

Kengo Kusano

Keyword(s):

Pulmonary Vein ◽

Atrial Tachycardia ◽

Superior Vena ◽

Vena Cava ◽

P Wave ◽

Induction Method ◽

Voluntary Cough ◽

Wave Morphology ◽

Abstract Background Cough-induced atrial tachycardia (AT) is extremely rare and its electrical origin remains largely unknown. Atrial tachycardias triggered by pharyngeal stimulation, such as swallowing or speech, appears to be more common and the majority of them originate from the superior vena cava or right superior pulmonary vein (PV). Only one case of swallow-triggered AT with right inferior pulmonary vein (RIPV) origin has been reported to date. Case summary We present a case of a 41-year-old man with recurring episodes of AT in the daytime. He underwent electrophysiology study without sedation. Atrial tachycardia was not observed when the patient entered the examination room and could not be induced with conventional induction procedures. By having the patient cough periodically on purpose, transient AT with P-wave morphology similar to the clinical AT was consistently induced. Activation mapping of the AT revealed a centrifugal pattern with the earliest activity localized inside the RIPV. After successful radiofrequency isolation of the right PV, AT was no longer inducible. Discussion In the rare case of cough-induced AT originating from the RIPV, the proximity of the inferior right ganglionated plexi (GP) suggests the role of GP in triggering tachycardia. This is the first report that demonstrates voluntary cough was used to induce AT. In such cases that induction of AT is difficult using conventional methods, having the patient cough may be an effective induction method that is easy to attempt.

P-wave morphology in focal atrial tachycardia using a 3D numerical model of the heart

International Journal of Medical Engineering and Informatics ◽

10.1504/ijmei.2016.077442 ◽

2016 ◽

Vol 8 (3) ◽

pp. 263

Author(s):

Dror Amar ◽

Shimon Abboud

Keyword(s):

Numerical Model ◽

Atrial Tachycardia ◽

P Wave ◽

Wave Morphology ◽

3D Numerical Model

Developments in Cardiovascular Medicine - Cardiac Arrhythmias, Pacing & Electrophysiology ◽

Sinus Node Reentrant Tachycardia Versus Ectopic Atrial Tachycardia: Where Lies the Difference?

10.1007/978-94-011-5254-9_1 ◽

1998 ◽

pp. 3-9 ◽

Cited By ~ 1

Author(s):

Hein Heidbüchel

Keyword(s):

Atrial Tachycardia ◽

Sinus Node ◽

Reentrant Tachycardia ◽

Ectopic Atrial Tachycardia ◽

The Difference

P-wave Morphology in Focal Atrial Tachycardia: An Updated 2021 Algorithm to Predict Site of Origin

Heart Lung and Circulation ◽

10.1016/j.hlc.2021.06.158 ◽

2021 ◽

Vol 30 ◽

pp. S163

Author(s):

P. Kistler ◽

D. Chieng ◽

I. Tonchev ◽

H. Sugumar ◽

A. McLellan ◽

...

Keyword(s):

Atrial Tachycardia ◽

P Wave ◽

Wave Morphology ◽

Focal Atrial Tachycardia

Slow pseudo sinus rhythm and atrial tachycardia of right superior venous pulmonary origin

Oxford Medical Case Reports ◽

10.1093/omcr/omab093 ◽

2021 ◽

Vol 2021 (10) ◽

Author(s):

Thierry Verbeet ◽

Thomas Nguyen ◽

Alexandre Almorad ◽

Maurice Jottrand ◽

Thierry Wauters ◽

...

Keyword(s):

Heart Rate ◽

Sinus Rhythm ◽

Atrial Tachycardia ◽

P Wave ◽

Ectopic Activity ◽

Clear Cut ◽

Sinus Rate ◽

Wave Morphology ◽

The Right ◽

Atrial Rhythm

ABSTRACT Paroxysmal atrial tachycardia usually presents as a sudden acceleration of the atrial rate combined with modifications of the P wave morphology. A 22-year-old patient presented with very fast and very slow atrial ectopic activity. He complained of repetitive episodes of fast tachycardia, some accompanied with dizziness. When the ectopic discharge was slow, no clear-cut difference between the sinus rate and the ectopic rate was seen and thus the atrial rhythm appeared quite regular. The ectopic focus was situated deep inside the right upper pulmonary vein (RSPV). After RSPV isolation a persistent sinus rhythm was established and since then the patient has been asymptomatic for 3 years. Thus, subtle changes in the P wave morphology without a significant change in the heart rate in patients presenting with palpitations can give a clue to the diagnosis of the tachycardia and the localization of the ectopic focus.