What are the treatment options for atrial tachycardia (supraventricular tachycardia)?

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Last updated: February 14, 2025 • View editorial policy

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:

  • Focal atrial tachycardia, with success rates between 80% and 95% 6, 9
  • Typical atrial flutter, with high success rates 10
  • Atypical atrial flutter, with variable success rates depending on the lesional or de novo macroreentrant circuit 10

References

Research

'True' atrial tachycardia.

European heart journal, 1998

Research

[Current treatment of supraventricular tachycardia: drug therapy].

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete, 1993

Research

[Supraventricular tachycardias: mechanism, diagnosis and therapy].

Schweizerische medizinische Wochenschrift, 1996

Research

Focal atrial tachycardia.

Heart (British Cardiac Society), 2010

Research

Atrial tachycardia: mechanisms and management.

Expert review of cardiovascular therapy, 2008

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.