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Atrial tachycardias, although relatively uncommon, comprise a substantial subset of supraventricular tachycardias. Focal atrial tachycardias are thought to arise from pinpoint sources in the atrium that fire at a faster rate than the sinus node. Most such tachycardias respond to adenosine by termination (suggesting triggered activity) or transient suppression (suggesting automaticity). A minority of focal atrial tachycardias, however, do not respond to adenosine.
Investigators at the Cornell University Cardiac Electrophysiology Laboratory studied 80 cases of focal atrial tachycardia. Upon adenosine infusion, 67 (84%) of the tachycardias terminated, five (6%) were transiently suppressed, and six (8%) showed no response. The six adenosine-inse…