6th March 2024

Focal Atrial Tachycardia

Accelerated atrial activity arising from a focal area within the atria other than the SA node presents with a regular but abnormal p wave morphology with a rate >100/bpm. There may be some level of AV block but 1:1 AV conduction of atrial tachycardias can result in dangerous exacerbations of the ventricular rate.  

A variation of this is multifocal atrial tachycardia, most commonly seen in patients with COPD or congestive heart failure. As above, there is an accelerated atrial rhythm but there are at least three distinct p wave morphologies. The management is similar to AF with rate and rhythm control, but anticoagulation does not play a role here due to relatively organised atrial activity.