Paroxysmal Atrial Tachycardia

Paroxysmal atrial tachycardia (PAT) consists of periods of very rapid and regular heart beats that begin and end abruptly.Your heart rate suddenly shoots upward to 220 beats a minute, and it feels like it won't slow down. There may be an abnormal electrical pathway between the atria and the ventricles (an arrhythmia called atrioventricular reciprocating supraventricular tachycardia). Much less commonly, the atria may generate abnormal rapid or circling impulses (an arrhythmia called true paroxysmal atrial tachycardia). Sometimes P.A.T. can be caused by an extra piece of tissue in the heart that acts to “short circuit” the electrical system and causes fast heart beats. This is called Wolff Parkinson White Syndrome or WPW. This is a more common cause of P.A.T. in the older child. This is a non-surgical method that allows a doctor with the use of a catheter to actually map out the electrical system of the heart and burn the area of tissue causing the problem and cure it completely. The fast rate may be triggered by a premature atrial beat that sends an impulse along an abnormal electrical path to the ventricles. Other causes stem from anxiety, stimulants, overactive thyroid, and in some women, the onset of menstruation. Certain conditions" include alcohol excess, too much stress, the intake of caffeine (including that in Coke and other colas), the presence of hyperthyroidism (overactive thyroid) and excessive thyroid hormone intake. Other drugs sometimes used include Verapamil, Flecanide, Quinidine, Sotolol, Norpace and Amiodarone. These are more potent drugs and tend to have more side effects. In some children sometimes-simple maneuvers such as coughing, doing sit-ups, headstands or ice water to the face may be enough to “break” a spell of PAT.
A period of very rapid and regular heart beats that begins and ends abruptly. Paroxysmal supraventricular tachycardia may be triggered by a premature heartbeat that repeatedly activates the heart at a fast rate. Atrial tachycardia is defined as a supraventricular tachycardia (SVT) that does not require the atrioventricular (AV) junction, accessory pathways, or ventricular tissue for initiation and maintenance of the tachycardia. The reason P.A.T. can be dangerous is that when the heart is beating extremely fast (more than 200 beats per minute) it may not have enough time to fill or empty adequately. If this condition is allowed to persist for a long period of time (say four to six hours) the heart will begin to fail or not be able to pump enough blood. When this happens the patient will turn pale and possibly breath faster than normal. Ventricular tachycardia may be monomorphic (typically regular rhythm originating from a single focus with identical QRS complexes) or polymorphic (may be irregular rhythm, with varying QRS complexes). The abnormal signals produce an abnormal heart rhythm called an arrhythmia. These signals begin as the result of heart disease such as mitral valve disorders, problems with the walls of the atria, or preexcitation syndromes (when the ventricles are stimulated to contract too early and too often). Much less commonly, the atria may generate abnormal rapid or circling impulses (an arrhythmia called true paroxysmal atrial tachycardia). The fast heart rate tends to begin and end suddenly and may last from a few minutes to many hours. Though seldom life-threatening, paroxysmal atrial tachycardia produces annoying symptoms which can include lightheadedness, chest pain, palpitations, anxiety, sweating, and shortness of breath.

Causes of Paroxysmal Atrial Tachycardia

The common Causes of Paroxysmal Atrial Tachycardia :

• When it arises in patients with congenital heart disease who have undergone corrective or palliative cardiac surgery, such as a Fontan procedure, the occurrence of an atrial tachycardia can have potentially life-threatening consequences.
• It is often associated with hypoxia and sympathetic stimulation.
• Digitalis intoxication is one of the important causes of atrial tachycardia, with triggered activity as the underlying mechanism.
• Other serious health problems, such as chronic obstructive pulmonary disease , heart failure , pneumonia , or metabolic problems.
• It can be a form of a re-entry tachycardia (an electrical current is caught in a reentrant loop, excessively stimulating the heart), as in the case of Wolff-Parkinson-White syndrome .
• Though seldom life-threatening, paroxysmal atrial tachycardia produces annoying symptoms which can include lightheadedness, chest pain , palpitations , anxiety, sweating, and shortness of breath .

Symptoms of Paroxysmal Atrial Tachycardia

Some are common Symptoms of Paroxysmal Atrial Tachycardia :

• Lightheadedness
• Palpitations
• Shortness of breath
• Chest tightness
• Rapid pulse
• Anxiety , feeling of impending doom
• Weakness, dizziness, or feeling faint
• Rarely, loss of consciousness
• Fainting
• Rapid heartbeat or palpitations

Treatment of Paroxysmal Atrial Tachycardia

Here is the list of the methods for treating Ischaemic Mitral Stenosis :

• A curative procedure introduced in the 1990's which is currently the treatment of choice for most PSVT's.
• Pacemakers very occasionally used in children with PSVT which hasn't responded to any other treatment.
• If manual methods are not sufficient to control the attacks, there are other treatments that your physician may recommend.
• Surgical modification of the electrical conduction pathway (the pathways in the heart that conduct the impulse to contract) this may be recommended in some cases when other heart surgery for other reasons is also indicated.
• This technique can cause severe slowing of the heart rate.
• Both catheter-directed radiofrequency ablation and intraoperative resection or cryoablation of VT foci have been successful with monomorphic VTs; however, their utility is unproved for patients with polymorphic VT.
• Aside from treating isolated episodes of PSVT, some patients may require a long-term or definitive treatment of the PVST which is directed toward the prevention or complete eradication of further episodes or arrhythmia.
• For unstable patients, conduct simultaneous evaluation and therapy.