Electrocardiographic Diagnosis of Atrial Tachycardia: Classification, P-Wave Morphology, and Differential Diagnosis with Other Supraventricular Tachycardias

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Abstract

Atrial tachycardia is defined as a regular atrial activation from atrial areas with centrifugal spread,caused by enhanced automaticity, triggered activity or microreentry. New ECG classificationdifferentiates between focal andmacroreentrant atrial tachycardia. Macroreentrant atrial tachycardiasinclude typical atrial flutter and other well characterized macroreentrant circuits in right and leftatrium. Typical atrial flutter has been described as counterclockwise reentry within right atrial and itpresents a characteristic ECG “sawtooth” pattern on the inferior leads. The foci responsible for focalatrial tachycardia do not occur randomly throughout the atria but tend to cluster at characteristicanatomical locations. The surface ECG is a very helpful tool in directing mapping to particularareas of interest. Atrial tachycardia should be differentiated from other supraventricular tachycardias.We propose a diagnostic algorithm in order to help the physician to discriminate among those.Holter analysis could offer further details to differentiate between atrial tachycardia and anothersupraventricular tachycardia. However, if the diagnosis is uncertain, it is possible to utilize vagalmaneuvers or adenosine administration. In conclusion, in spite of well–known limits, a goodinterpretation of ECG is very important
Lingua originaleEnglish
pagine (da-a)314-327
Numero di pagine14
RivistaAnnals of Noninvasive Electrocardiology
Volume20
Stato di pubblicazionePublished - 2015

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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