From the Guidelines
Atrial tachycardia (supraventricular tachycardia) can be treated with catheter ablation, drug therapy options such as beta blockers, diltiazem, or verapamil, and antiarrhythmic agents like flecainide or propafenone.
Treatment Options
- Catheter ablation: a highly effective treatment with a high degree of success and low complication rate, especially for common types of SVT like AVNRT and AVRT 1
- Drug therapy options:
- Beta blockers: can be used to terminate atrial tachycardia, especially in patients with structurally normal hearts 2
- Diltiazem or verapamil: can be used to terminate atrial tachycardia, and may be used in combination with beta blockers for single-dose oral therapy 3
- Flecainide or propafenone: can be used to prevent recurrent episodes of atrial tachycardia, especially in patients without structural heart disease 4, 2
- Antiarrhythmic agents:
- Amiodarone or sotalol: may be used in patients who do not respond to other treatments, but have a higher risk of side effects 4 ### Considerations
- Patient selection: catheter ablation is generally recommended for patients with symptomatic atrial tachycardia who have not responded to drug therapy or have recurrent episodes 5
- Risk of complications: catheter ablation carries a small risk of complications, including valvular disruption, coronary occlusion, and cerebrovascular accident 5
- Single-dose oral therapy: may be considered for patients with infrequent episodes of atrial tachycardia who are well-tolerated and have no significant left ventricular dysfunction or sinus bradycardia 3
From the Research
Treatment Options for Atrial Tachycardia
The treatment options for atrial tachycardia (supraventricular tachycardia) include:
- Drug therapy: antiarrhythmic drugs such as class IC or class I agents, verapamil, beta-blockers, or amiodarone may be used to manage atrial tachycardia 6, 7
- Transcatheter radiofrequency ablation: a curative option with high success rates and low complication rates, particularly indicated in young patients or those with symptomatic WPW syndrome or drug-refractory AV-nodal reentry tachycardia 6, 8, 9
- Rate control: management of focal atrial tachycardias and macroreentry centers around rate control, antiarrhythmic therapy, ablation, and anticoagulation 10
Drug Therapy
Drug therapy for atrial tachycardia includes:
- Class IC or class I agents for re-entrant atrial tachycardia 6
- Verapamil, beta-blockers, or class IC agents for focal atrial tachycardia 6
- Amiodarone for patients who fail other treatments 6, 7
- Propafenone or flecainide for recurrent atrial fibrillation without or with minimal structural abnormalities 7
- Sotalol or amiodarone for coronary artery disease 7
Radiofrequency Ablation
Radiofrequency ablation is a highly successful treatment option for: