What are atrial tachycardia and premature atrial/ventricular complexes?

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From the Guidelines

Atrial tachycardia and premature atrial/ventricular complexes are abnormal heart rhythms that can be concerning, so it's essential to consult a doctor for proper evaluation and treatment.

Definition of Atrial Tachycardia and Premature Complexes

Atrial tachycardia is a condition where the heart's upper chambers (atria) beat too quickly, often more than 100 times per minute, as seen in various supraventricular tachycardias 1. Premature complexes, also known as premature atrial contractions (PACs) or premature ventricular contractions (PVCs), occur when the atria or ventricles contract too early, disrupting the normal heartbeat.

Causes and Treatment

In some cases, medication such as beta blockers or anti-arrhythmic drugs may be prescribed to control the heart rate and rhythm, but the specific treatment should be guided by the underlying cause of the arrhythmia, such as atrioventricular nodal reentrant tachycardia (AVNRT) or atrioventricular reentrant tachycardia (AVRT) 1.

  • Lifestyle Changes: Reducing stress, avoiding stimulants like caffeine, and getting regular exercise can help manage symptoms and prevent episodes.
  • Medications: Beta blockers (e.g., metoprolol) or anti-arrhythmic drugs (e.g., flecainide) may be prescribed, but only under the guidance of a healthcare professional.
  • Seeking Medical Attention: It's crucial to seek medical attention if you experience symptoms such as palpitations, shortness of breath, dizziness, or chest pain, as these can be signs of an underlying condition that requires prompt attention.

Importance of Medical Evaluation

A doctor may recommend further testing, such as an electrocardiogram (ECG), to determine the underlying cause of the arrhythmia and develop an appropriate treatment plan 1.

From the Research

Atrial Tachycardia

  • Atrial tachycardia is a type of arrhythmia characterized by a fast heart rate that originates in the atria 2, 3.
  • It can be caused by premature atrial contractions (APCs), which can influence the heart conduction system and induce other arrhythmias 2.
  • Atrial tachycardia can present with multiple rhythms on an electrocardiogram (ECG), making it difficult to diagnose 2.

Premature Atrial Complexes (PACs)

  • PACs are common electrocardiographic findings in daily clinical practice that require further evaluation 4.
  • They are associated with age, brain natriuretic peptide (BNP) levels, intraventricular blocks, and left atrial diameter 4.
  • PACs can be abolished by radiofrequency ablation, resulting in the elimination of arrhythmia 2.
  • The response to PACs during tachycardia can help differentiate atrioventricular nodal re-entrant tachycardia (AVNRT) from focal junctional tachycardia (JT) 3.

Premature Ventricular Complexes (PVCs)

  • PVCs are also common electrocardiographic findings that require further evaluation 4.
  • They are associated with age, the use of calcium channel blockers, HDL-cholesterol levels, BNP levels, heart rate, left ventricular hypertrophy, and left ventricular ejection fraction 4.
  • PVCs can be related to uncontrolled cardiovascular risk factors, which can be addressed with medical advice and therapy in a primary care setting 4.

Treatment and Diagnosis

  • Ablation of PACs is a good alternative to medical therapy, with a comparable safety profile and at least comparable efficacy 5.
  • Ultra-high-density (UHD) mapping has improved the success rate of PAC ablation by identifying the point of earliest activation within the high-resolution map 5.
  • The diagnosis of atrial tachycardia and PACs can be challenging, and a thorough evaluation of the ECG and other diagnostic tests is necessary to determine the underlying cause of the arrhythmia 2, 4, 3, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Mechanism and interpretation of two-for-one response to premature atrial complexes during atrioventricular node re-entry tachycardia.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2021

Research

Mapping strategies and ablation of premature atrial complexes.

Herzschrittmachertherapie & Elektrophysiologie, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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