Focal Atrial Tachycardia Without Haemodynamic Instability: What to Do When Drug Therapy Has Failed to Terminate the Arrhythmia
This protocol addresses focal atrial tachycardia without haemodynamic instability — an organized atrial rhythm initiated from a discrete origin and spreading over both atria — in patients whose arrhythmia has not been terminated by pharmacological therapy.
Intravenous drug therapy was attempted — including agents such as i.v. ibutilide, i.v. flecainide or propafenone, or i.v. amiodarone — without achieving the target outcome of termination of the atrial tachycardia.
The failure of this pharmacological line is the trigger for escalation to the present protocol.
References
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 when drug therapy fails to convert or control the tachycardia.
DC cardioversion is usually effective in acutely terminating the tachycardia, irrespective of the mechanism.
DOI: 10.1093/eurheartj/ehz827
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