Focal atrial tachycardia (AT) is a rhythm originating in a region other than the sinus node, characterized by a P wave with a morphology different from the sinus P wave and an HR > 100 bpm. It arises from a small, circumscribed area from which activation spreads centrifugally through the atria.

Electrocardiographic Criteria

  • P wave with a morphology different from the sinus P wave
  • Classically, there are clearly defined isoelectric intervals between P waves in all leads
  • The RR interval may be regular when the AV ratio is constant (1:1, 2:1, etc.) or irregular if AV conduction is variable
  • Usually has a long RP interval

ECG in Focal Atrial Tachycardia

Electrocardiogram with focal atrial tachycardia

Focal atrial tachycardia. P waves with a morphology different from the sinus P wave and 2:1 AV conduction.

References

  1. Issa Z, Miller J, Zipes D. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3a ed. Philadelphia: Elsevier; 2019. 752 p.
  2. Brugada J, Katritsis DG, Arbelo E, Arribas F, et al. 2019 ESC Guidelines for themanagement of patients with supraventricular tachycardia. Eur Heart J. 2020;41(5):655–720.