Nonparoxysmal atrial tachycardia multifocal atrial tachycardia and automatic junctional tachycardia

These arrhythmias are due to an automatic mechanism and usually have precipitating factors. Carotid sinus massage does not affect the arrhythmia but may increase atrioventricular block, thereby slowing the ventricular response. Therapy is directed towards correcting the underlying mechanism, whether it be due to drug toxicity, electrolyte imbalance, pulmonary disease, or congestive heart failure. These arrhythmias can be very difficult to treat, particularly in an acutely ill patient. Class IA antiarrhythmics are occasionally as effective as those of classes IC and III. If these arrhythmias are not rapid and the patient is hemodynamically stable, simple observation may be indicated as the patient's acute illness is treated.

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