Key Points
- To investigate the clinical characteristics, etiology, underlying conditions, and management strategies for atrial tachycardia with block.
- Retrospective observational review of 40 episodes of atrial tachycardia with block across 32 patients monitored from 1965 through 1968.
- Patients were managed by discontinuing digitalis, administering peroral potassium chloride, and subsequently undergoing electroconversion after 3 to 4 days.
- Mitral valve disease was the predominant underlying condition, while aortic valve disease was nearly absent; only 9 of the 40 episodes had suspected digitalis toxicity, with no confirmed role for hypokalemia.
- Most episodes followed a persistent, continuous course rather than a paroxysmal pattern, causing significant clinical deterioration across the majority of patients.
- Treatment with potassium chloride followed by electroconversion after 3–4 days was effective and safe, with an overall mortality of 3 deaths out of 32 patients, all attributable to underlying disease.
Structured PICO
PPopulation32 patients (40 episodes) with atrial tachycardia with block observed between 1965 and 1968, frequently with underlying mitral valve disease.
IInterventionDiscontinuance of digitalis and peroral administration of potassium chloride, followed by electroconversion 3-4 days later.
OOutcomeMortality and treatment safety/efficacy.
In patients with atrial tachycardia with block, a treatment strategy of digitalis discontinuation, potassium supplementation, and delayed electroconversion was safe and effective with low mortality.