From the Guidelines
The heart can become randomly tachycardic due to various causes, including disorders of impulse initiation and abnormalities of impulse conduction, as stated in the 2016 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1. These causes can be broadly categorized into:
- Disorders of impulse initiation, which are often referred to as automatic, and can arise from tissues exhibiting abnormal automaticity in the atria, the AV junction, or vessels that communicate directly with the atria, such as the vena cava or pulmonary veins, as described in the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias 1.
- Abnormalities of impulse conduction, which can be re-entrant in nature, and may occur in different forms, including orthodromic AV re-entry and atrial flutter, as outlined in the 2016 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1. Other potential causes of random tachycardia include:
- Triggered activity, which is a tachycardia mechanism associated with disturbances of recovery or repolarization, as mentioned in the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias 1.
- Electrolyte imbalances, particularly potassium, magnesium, and calcium, which can affect the heart's electrical activity, as noted in the example answer.
- Structural heart problems, such as valve disorders, cardiomyopathy, or previous heart attacks, which can create abnormal electrical pathways, as stated in the example answer.
- Lifestyle factors, such as stress, anxiety, caffeine consumption, alcohol, and nicotine, which can contribute to the development of tachycardia, as mentioned in the example answer. It is essential to seek medical evaluation promptly if you experience recurrent episodes of unexplained tachycardia, as your doctor may recommend an ECG, Holter monitor, or other cardiac tests to identify the specific cause, and treatment depends on the underlying condition, as outlined in the example answer.
From the Research
Causes of Random Tachycardia
The heart can become randomly tachycardic due to various factors, including:
- Atrial fibrillation, which is the most common arrhythmia in the general population and is frequently associated with organic heart disease 2
- Ventricular tachyarrhythmias, which can be caused by conditions such as myocardial muscle deterioration and drug stimulation 3
- Supraventricular tachycardias, which can be caused by conditions such as atrioventricular nodal re-entrant tachycardias and atrioventricular re-entrant tachycardias 4
Triggers of Tachycardia
Certain triggers can cause the heart to become tachycardic, including:
- Myocardial infarction, which can lead to ventricular tachyarrhythmias 5
- Hyperthyroidism, which can increase the heart rate and lead to tachycardia 6
- Wolff-Parkinson-White syndrome, which can cause atrial fibrillation and ventricular tachycardia 6
- Drug stimulation, which can cause ventricular tachycardia 3
Management of Tachycardia
The management of tachycardia depends on the underlying cause and the stability of the patient, including:
- Antiarrhythmic medications, such as beta-blockers and calcium channel blockers, which can be used to manage stable ventricular tachycardia 2, 6
- Immediate cardioversion, which is required for unstable ventricular tachycardia 3
- Electrophysiologic study, which can be used to evaluate the efficacy of antiarrhythmic drugs in patients with sustained ventricular tachyarrhythmias 5