Treatment of Focal Atrial Tachycardia with Haemodynamic Instability

When focal atrial tachycardia presents alongside haemodynamic instability, the clinical situation calls for immediate and decisive management. The scenario and primary treatment goal are outlined below.

Focal AT is an organised atrial rhythm initiated from a discrete origin, spreading over both atria in a centrifugal pattern. When haemodynamic instability accompanies this arrhythmia, the choice of intervention is driven by that instability.

Management approach

Haemodynamically unstable focal atrial tachycardia is managed with an electrical approach. The complete protocol — including specific parameters, sequencing, and clinical decision points — is available in full via the link below.

Clinical goal

Termination of the tachycardia.

References

DOI: 10.1093/eurheartj/ehz827

Focal AT is defined as an organized atrial rhythm ≥100 b.p.m. initiated from a discrete origin and spreading over both atria in a centrifugal pattern.

Synchronized DC cardioversion is recommended for haemodynamically unstable patients.

DC cardioversion is usually effective in acutely terminating the tachycardia, irrespective of the mechanism.