Atrial Tachycardia: Symptoms, Causes, Diagnosis & Treatment — Complete Guide

Medically reviewed by {{Dr. Baraa Alnahhal, MD|https://www.rinnit.com/dr-baraa-alnahhal}} · Last reviewed: October 2026

Quick Answer

Atrial tachycardia is an arrhythmia and type of supraventricular tachycardia in which faulty electrical signals make the heart beat more than 100 times a minute, typically 150 to 200. Symptoms range from a racing heartbeat to chest pain, or none at all. It usually is not life-threatening, but a prolonged fast heartbeat with chest pain is a 911 emergency.

What the research says

• A modified Valsalva maneuver converts a racing heart far more often than the standard one. In the REVERT randomized trial of adults in emergency departments with supraventricular tachycardia (excluding atrial fibrillation and flutter), 43% (93 of 214) returned to normal rhythm within a minute with a modified Valsalva maneuver (strain, then lying back with legs raised) versus 17% (37 of 214) with the standard maneuver (adjusted OR 3.7; 95% CI 2.3–5.8), with no serious adverse events. (Appelboam et al., Lancet, 2015) [3]

• Catheter ablation of atrial tachycardia after mitral valve surgery is safe and usually works at first, but benefit can fade. A meta-analysis of 14 studies (227 patients) found 95% acute success and a pooled 0% rate of major periprocedural complications; sinus rhythm was maintained in 71% at mid-term follow-up but only 47% long term, mainly because of recurring atrial fibrillation. (Marazzato et al., J Cardiovasc Electrophysiol, 2020) [4]

Atrial Tachycardia at a Glance

Aspect	Summary
What it is	An arrhythmia — a fast heartbeat starting in the heart's upper chambers
Episode heart rate	More than 100 bpm, typically 150–200 bpm, returning to 60–80 bpm
How episodes start	Slowly or suddenly; may come and go or be ongoing
Main symptoms	Palpitations, chest pain, dizziness, fainting, shortness of breath
Danger level	Usually not life-threatening, but prolonged fast beats can weaken the heart muscle
Key test	Electrocardiogram (ECG)
First-line treatment	Vagal maneuvers and medicines
Advanced treatment	Cardioversion, catheter ablation, pacemaker

What Is Atrial Tachycardia?

Atrial tachycardia is an irregular heartbeat, called an arrhythmia. It is a type of supraventricular tachycardia — fast-heartbeat conditions that start above the heart's lower chambers.

During an atrial tachycardia episode, the heart beats more than 100 times a minute. Then it returns to a normal heart rate of around 60 to 80 beats a minute. An episode may start slowly, or it may start suddenly and quickly.

Atrial tachycardia is common. It may happen in people who have had heart surgery or who are pregnant. Infections, stimulant medicines, or alcohol use may trigger it.

What are the symptoms of atrial tachycardia, and what does it feel like?

The main symptom of atrial tachycardia is a very fast heartbeat. Typically, during atrial tachycardia, the heart beats 150 to 200 times a minute. The fast heartbeat may come and go suddenly, or it can be ongoing.

Other symptoms may include:

• Pounding or fluttering feelings in the chest or neck, called palpitations

• Chest pain

• Fainting or almost fainting

• Lightheadedness or dizziness

• Shortness of breath

• Sweating

• Weakness or extreme tiredness

• Nausea

It is important to know that some people with atrial tachycardia do not notice symptoms at all.

Symptoms in Infants and Young Children

Atrial tachycardia symptoms may be hard to see in infants and young children. In this age group, watch for:

• Poor feeding

• Sweating

• Irritability

• Changes in skin color

If your infant or young child has any of these symptoms, talk with a healthcare professional.

When to See a Doctor

Go to the emergency room — call 911 or your local emergency number — if you have a very fast heartbeat that lasts for more than a few minutes, or if a fast heartbeat occurs with chest pain, dizziness, shortness of breath, or weakness.

Make an appointment for a healthcare checkup if you have:

• A very fast heartbeat for the first time

• An irregular heartbeat that lasts longer than a few seconds

What Causes Atrial Tachycardia?

Atrial tachycardia is caused by faulty electrical signals in the heart. These electrical signals are what control the heartbeat.

In atrial tachycardia, a change in these signals makes the heartbeat start too early in the heart's upper chambers (the atria). This causes the heart to beat too fast. The heart then is not able to fill with blood properly — which is why the racing beats can feel pounding, tiring, or unsettling.

Step	What Happens
1	Electrical signals that control the heartbeat become faulty
2	The heartbeat starts too early in the heart's upper chambers
3	The heart beats too fast — typically 150 to 200 times a minute
4	The heart cannot fill with blood properly between beats

What are the risk factors for atrial tachycardia?

Anyone can get atrial tachycardia. But some health conditions or treatments can increase your risk.

Category	Risk Factors
Heart conditions	Coronary artery disease, heart valve disease, and other heart diseases; heart failure; heart defect present at birth (congenital heart defect); previous heart surgery
Other medical conditions	Sleep apnea, thyroid disease, lung disease including chronic obstructive pulmonary disease (COPD), diabetes
Medicines	Some medicines, including those used to treat asthma, allergies, and colds
Lifestyle factors	Emotional stress, too much caffeine, heavy alcohol use (more than 15 drinks a week for men and 8 or more a week for women), smoking and nicotine use, stimulant drugs including cocaine and methamphetamine

What are the complications of atrial tachycardia?

Atrial tachycardia isn't usually life-threatening. However, it can be a concern if you have heart damage or another heart condition.

If the very fast heartbeat continues, it may weaken the heart muscle — a good reason to take fast or prolonged episodes seriously and get them evaluated.

How is atrial tachycardia diagnosed?

To diagnose atrial tachycardia, a healthcare professional examines you and listens to your heart, takes your blood pressure, and asks questions about your symptoms, health habits, and medical history.

Core Tests

Test	What It Does
Blood tests	Check for thyroid disease, heart disease, or other conditions that can affect the heartbeat
Electrocardiogram (ECG or EKG)	The most common test to diagnose tachycardia — shows how the heart is beating. Small sensors called electrodes attach to the chest and sometimes the arms and legs; wires connect the sensors to a computer, which prints or displays the results
Holter monitor	A small ECG device worn for a day or more to record the heart's activity during daily activities
Echocardiogram	Also called a heart ultrasound — uses sound waves to make pictures of the beating heart, showing its size and structure and how blood moves through the heart and valves

Tests That Try to Trigger an Episode

Other tests may be done to try to trigger an episode of atrial tachycardia, giving more information about the heart:

Test	What It Does
Exercise (stress) test	The heart's activity is watched while you ride a stationary bicycle or walk on a treadmill. If you can't exercise, you may be given medicine that affects the heart in a way similar to exercise
Electrophysiological (EP) study and cardiac mapping	A series of tests that show how electrical signals spread through the heart during each heartbeat. It may confirm tachycardia or find where in the heart the faulty signaling occurs. Done in a hospital

What are the treatment options for atrial tachycardia?

Treatment of atrial tachycardia depends on what causes it and how severe it is.

The Treatment Ladder

Treatment	How It Works
1. Vagal maneuvers	Simple but specific actions — coughing, putting an ice pack on the face, or pushing down as if having a bowel movement — can slow the heart rate. These actions affect the vagus nerve, which helps control the heartbeat
2. Medicines	Given to control the heart rate and reset the heart rhythm. Some medicines may need to be given by IV
3. Cardioversion	Paddles or patches on the chest deliver an electrical shock to the heart. The quick, low-energy shock resets the heart's rhythm. An option if vagal maneuvers or medicine don't work
4. Catheter ablation	A doctor guides a thin, flexible tube (catheter) through a blood vessel — usually in the groin — up to the heart. Sensors on the catheter tip use heat energy (radiofrequency energy) to create tiny scars that block faulty electrical signals, restoring a regular heartbeat
5. Pacemaker	A small device placed in the chest that helps control the heartbeat — when it finds an irregular heartbeat, it sends an electrical signal to correct the rhythm. Needed if other treatments don't work; typically placed together with a treatment called AV node ablation

The steps are often tried in order — simple maneuvers and medicines first, then shock-based and catheter-based treatments, with a pacemaker as a last-resort control device.

How should you prepare for an atrial tachycardia appointment?

If you have a very fast heartbeat, call your healthcare professional. If the fast heartbeat is severe and lasts longer than a few minutes, seek immediate medical help.

Your healthcare professional may send you to a doctor trained in heart diseases, called a cardiologist. You also might see a doctor trained in heart rhythm disorders, called an electrophysiologist. Because appointments can be brief, it's helpful to be prepared.

What You Can Do

1. Call ahead to check for special instructions — for example, you may be told not to drink or eat before a cholesterol test

2. List any symptoms, even those that may not seem related to atrial tachycardia

3. List important personal information, including any big life changes or major stresses

4. List all medicines you take, including vitamins, supplements, and over-the-counter medicines, with doses

5. List questions for your care team

Questions to Ask Your Doctor

1. What is causing my fast heart rate?

2. What tests do I need?

3. What treatment do you recommend?

4. What are the risks of atrial tachycardia?

5. How often do I need checkups?

6. How do my other health conditions or medicines affect my heartbeat?

7. Do I need to change my diet or activities?

8. Is there any helpful information I can take home? What websites do you recommend?

Questions the Doctor Will Likely Ask

1. When did your symptoms start?

2. How often does your heart race?

3. How long does your fast heartbeat last?

4. What makes your symptoms worse?

5. Do you always have symptoms, or do they come and go?

6. Does anyone in your family have heart disease or a history of irregular heartbeats?

7. Has anyone in your family died suddenly or had sudden cardiac arrest?

8. Do you smoke or have you ever smoked?

9. How much caffeine or alcohol do you use, if any?

10. What medicines are you taking?

11. Do you have any health conditions such as high blood pressure, high cholesterol, or diabetes that could affect your heart health?

FAQ: Atrial Tachycardia Questions People Also Ask

What is atrial tachycardia?

Atrial tachycardia is an irregular heartbeat (arrhythmia) and a type of supraventricular tachycardia. During an episode, the heart beats more than 100 times a minute — typically 150 to 200 times a minute — before returning to a normal rate of around 60 to 80 beats a minute.

What does an atrial tachycardia episode feel like?

The main symptom is a very fast heartbeat, often with pounding or fluttering feelings in the chest or neck called palpitations. People may also have chest pain, fainting or near-fainting, dizziness, shortness of breath, sweating, weakness, or nausea. Some people notice no symptoms at all.

What causes atrial tachycardia?

Faulty electrical signals in the heart make the heartbeat start too early in the heart's upper chambers. This makes the heart beat too fast and unable to fill with blood properly. Episodes may start slowly or suddenly.

When should a fast heartbeat be treated as an emergency?

Call 911 or your local emergency number if a very fast heartbeat lasts for more than a few minutes, or if it occurs with chest pain, dizziness, shortness of breath, or weakness.

How is atrial tachycardia diagnosed?

The most common test is an electrocardiogram (ECG). Other tests include a Holter monitor worn for a day or more, an echocardiogram (heart ultrasound), blood tests, an exercise (stress) test, and an electrophysiological (EP) study with cardiac mapping to locate the faulty signaling.

How is atrial tachycardia treated?

Treatment depends on the cause and severity. Options include vagal maneuvers (coughing, an ice pack on the face), medicines to control rate and reset rhythm, cardioversion (a quick low-energy electrical shock), catheter ablation (tiny scars that block faulty signals), and, if other treatments fail, a pacemaker.

Is atrial tachycardia dangerous?

Atrial tachycardia isn't usually life-threatening, but it can be a concern if you have heart damage or another heart condition. If a very fast heartbeat continues, it may weaken the heart muscle — which is why episodes should be evaluated rather than ignored.

Conclusion

By now, you understand the essentials of this common but often misunderstood heart rhythm condition:

• Electricity drives it. Atrial tachycardia begins when faulty electrical signals make the heartbeat start too early in the heart's upper chambers — a wiring issue, not necessarily a structural one.

• Know the numbers — and the alarms. A normal resting rate sits at 60–80 bpm; during an episode it jumps above 100, usually 150–200 bpm. And a fast heartbeat lasting more than a few minutes, or paired with chest pain, dizziness, shortness of breath, or weakness, is a 911 emergency.

• Treatments are staged. Most people start with simple vagal maneuvers or medicines; cardioversion, catheter ablation, and pacemakers stand ready if those aren't enough.

This guide has walked you through the symptoms and emergency signs, the electrical cause, the risk factors and lifestyle triggers, the diagnostic tests, and the full treatment ladder.

If you want to continue exploring heart rhythm health, our related guide is a natural next stop: the Atrial Fibrillation Complete Guide — another rhythm condition that also starts in the heart's upper chambers.

Medical disclaimer: The information in this article is for general educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your individual condition.

Related Reading

Valsalva Maneuver: How to Do It and When It's Used explains a breathing technique that can stop a fast heartbeat.

References

1. Mayo Clinic. Atrial tachycardia — Symptoms & causes. Accessed October 12, 2026. https://www.mayoclinic.org/diseases-conditions/atrial-tachycardia/symptoms-causes/syc-20573298

2. Mayo Clinic. Atrial tachycardia — Diagnosis & treatment. Accessed October 12, 2026. https://www.mayoclinic.org/diseases-conditions/atrial-tachycardia/diagnosis-treatment/drc-20573299

3. Appelboam A, Reuben A, Mann C, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015;386(10005):1747-1753. PMID 26314489. https://doi.org/10.1016/S0140-6736(15)61485-4

4. Marazzato J, Cappabianca G, Angeli F, et al. Catheter ablation of atrial tachycardias after mitral valve surgery: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2020;31(10):2632-2641. PMID 32652775. https://doi.org/10.1111/jce.14666