• The Tachycardias (Fast Heart Rates)
  • Atrial Fibrillation
  • Atrial Flutter
  • Atrioventricular Nodal Reentrant Tachycardia
  • Atrioventricular Tachycardia and Wolff-Parkinson-White Syndrome
  • Atrial Fibrillation and Wolff-Parkinson-White Syndrome
  • The Atrial Tachycardias: Multifocal Atrial Tachycardia and (unifocal) Atrial Tachycardia

If you are having symptoms of a fast heart rhythm, here are some things to do until help arrives.

If you having symptoms of a fast heart rhythm and you don't know what kind you are having, you should go to a medical facility while you are experiencing the fast rhythm so that an electrocardiogram ("12-lead ECG") can be obtained. The 12-lead ECG of the fast heart rhythm is the best way to find out just what kind of fast heart rhythm you are having.

If you are having symptoms of a fast heart rhythm, here are some things to do until help arrives.

Atrial flutter is less common than atrial fibrillation, but is similar in some other respects. The atria contract in an organized way, by contrast with the disorganized contractions of atrial fibrillation. The atrial rate is usually about 300 beats per minute (bpm), compared with 500-600 bpm in atrial fibrillation. Because the contractions are organized, the risk of stroke in atrial flutter is much less than it is in atrial fibrillation. On the other hand, the drug treatments for slowing the rate are sometimes not as effective in atrial flutter because of the regular atrial rate (at 300 bpm). That is, enough drug(s) must be given to cut the rate by four-fold, to about 75 bpm. Too little drug will yield a heart rate of 150 bpm, which can be uncomfortable. Too much drug can result in heart rates in the 30's or lower, which can be dangerous.

Some physicians are recommending that people who have atrial flutter should be anticoagulated just the same as people who have atrial fibrillation. The reason for this is that newer studies are showing that people who have atrial flutter do have more strokes than those who don't, but have fewer than those who have atrial fibrillation. It is wise to ask your doctor about this if you have atrial flutter.

Atrial flutter is curable in about 70% of patients by means of catheter-mediated radiofrequency ablation. In the unsuccessful cases of people who undergo radiofrequency ablation, either the flutter cannot eliminated or atrial fibrillation develops. Note that atrial fibrillation, which seems to have a different cause in the heart from that of atrial flutter, can be cured by open-heart surgery currently; cure by radiofrequency ablation has been reported as an experimental procedure. For most patients at this time, however, drug treatment provides sufficient relief from symptoms of both atrial flutter and atrial fibrillation.

If you are having symptoms of a fast heart rhythm, here are some things to do until help arrives.

If you are having these symptoms and you do not know why, you should go to a medical facility while you are experiencing the fast rhythm so that an electrocardiogram ("12-lead ECG") can be obtained. The 12-lead ECG of the fast heart rhythm is the best way to find out just what kind of fast heart rhythm you are having.

When the rhythm persists, it can sometimes be stopped by the Valsalva maneuver or by carotid sinus massage. There are several drugs that are quite effective at stopping this rhythm, of which adenosine is usually best because it acts quickly and then disappears quickly from the body.

Prevention of this tachycardia can be accomplished with certain medications. However, the treatment of first choice these days is catheter-mediated radiofrequency ablation. This technique can cure 95-99% of patients when it is performed by experienced physicians.

Atrioventricular reentrant tachycardia and Wolff-Parkinson-White Syndrome both result from the same congenital abnormality in the heart: accessory pathways. Accessory pathways, because they provide additional ways for electricity to travel through the heart, create a condition in which electricity can travel in a circle: down the AV node and back up the pathway, or visa versa. Each time electricity travels such a circle, it generates a heart beat. Because it can travel rapidly, the heart can go quite fast. The resulting rhythm is called "atrioventricular reentrant tachycardia".

The symptoms of atrioventricular reentrant tachycardia usually are a combination of palpitations, faintness, and/or shortness of breath. In some cases, the person will notice only "pounding" of the heart. In other cases, the person may pass out with very little warning. The rhythm usually starts very suddenly and, when it stops, stops abruptly. It can be brought on by exercise, emotion or excitement, drinking caffeinated beverages, or taking certain medicines for asthma or colds.

If you are having symptoms of a fast heart rhythm, here are some things to do until help arrives.

If you are having these symptoms and you do not know why, you should go to a medical facility while you are experiencing the fast rhythm so that an electrocardiogram ("12-lead ECG") can be obtained. The 12-lead ECG of the fast heart rhythm is the best way to find out just what kind of fast heart rhythm you are having.

When the rhythm persists, it can sometimes be stopped by the Valsalva maneuver or by carotid sinus massage. There are several drugs that are quite effective at stopping this rhythm, of which adenosine is usually best because it acts quickly and then disappears quickly from the body.

Prevention of this tachycardia can be accomplished with certain medications. However, the treatment of first choice these days is catheter-mediated radiofrequency ablation. This technique can cure 95-99% of patients when it is performed by experienced physicians.

When atrial fibrillation occurs in people who have Wolff-Parkinson-White (WPW) Syndrome, the heart can go very fast. Rates up to 375 beats per minute have been documented. These rates are so fast that they can cause the rhythm to change to ventricular fibrillation, resulting in immediate death. Because it is hard to predict how fast the heart will go in a person with WPW, many experts recommend cure of the condition by radiofrequency ablation of the accessory pathway in any patient with a delta wave who has symptoms of either atrioventricular tachycardia or atrial fibrillation.

If you are having symptoms of a fast heart rhythm, here are some things to do until help arrives.

Prevention of this tachycardia can be accomplished with certain medications. However, the treatment of first choice these days is catheter-mediated radiofrequency ablation. This technique can cure 95-99% of patients when it is performed by experienced physicians.

• Multifocal atrial tachycardia is seen mostly in people whose lungs are not working well. The best treatment is to improve the function of the lungs. If this cannot be accomplished, verapamil sometimes helps to reduce the heart rate but digitalis does not.

• (Unifocal) atrial tachycardia can be seen in people whose hearts are otherwise normal. It accounts for about 5% of cases of supraventricular tachycardia. It can be treated with medications or with radiofrequency ablation. Because it can be harder to cure with ablation, medications are used more often with atrial tachycardias than in other types of supraventricular tachycardia.