Tachycardia Induced Atrial Fibrillation: What Incidence? How to Diagnose and Treat It?

Abstract

Atrial fibrillation is the most common supraventricular arrhythmia in the clinical setting. Some patients present both atrial fibrillation and other supraventricular tachycardias such as focal atrial tachycardia, common and uncommon atrial flutter, atrioventricular reentrant tachycardia related to an overt or a concealed Kent bundle, or atrioventricular nodal reentrant tachycardia. E.N. Prystowsky [1] suggested that all the above mentioned forms of paroxysmal supraventricular tachycardia can trigger atrial fibrillation, a phenomenon he referred to as “tachycardia-induced tachycardia”. Potential factors affecting conversion of sustained atrial and nonatrial tachycardias to atrial fibrillation include tachycardia cycle length [2, 3], particular electrophysiological characteristics of the triggering arrhythmia [1] and contraction-excitation feed-back [4]. As to the latter phenomenon, it has been demonstrated that after the onset of some supraventricular tachycardias, a sudden dilatation of the atria can occur [1]. Subsequently, as changes in mechanical stress can alter cardiac membrane potential (contraction-excitation feedback), it is possible that sudden dilatation of the atria affects cardiac membrane potential and leads to atrial fibrillation.