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Paroxysmal atrial tachycardia
Posted Tue, 30 May 2000
Question
Please may I have some information on paroxysmal atrial tachycardia?
Answer
Paroxysmal atrial tachycardia (PAT), is one of the tachyarrhythmias, meaning that this is a fast irregularity of the heart beat.
There are three different types, the names of which are not really important, but which refer to different ways in which the abnormally fast rhythm arises.
All these arrhythmias result from problems in what is called the conducting system of the heart, which is the tissue in the heart muscle which conducts the electrical impulses which make the heart beat.
The fast heart beat usually starts spontaneously (paroxysmal) and is typically around 160 to 200 beats per minute. The symptoms are those of palpitations, which may be tolerated differently by individuals.
The condition is controlled either using various drugs, or can be stopped by what are called vagotonic manoeuvres, because they affect the vagus nerve. These are the Valsalva manoeuvre (holding your nose and blowing hard), plunging your face into cold water, or swallowing ice cold water. If these methods are ineffective the attack will often stop during sleep, but most people feel unwell and seek medical help instead.
If the attack needs to be stopped fast then intravenous therapy with verapamil is usually effective. Attacks can also be stopped using electrical cardioversion.
Occasionally the condition may be continuous and need surgery to the conducting system of the heart, after which a pacemaker is inserted.
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