Guideline sources The following summarized guidelines for the management of focal atrial tachycardia (FAT) are prepared by our editorial team based on guidelines from the European Society of Cardiology (ESC 2020) and the American Heart Association (AHA/HRS/ACC 2016). 1 2 Calculator NYHA functional classification f Guidelines 1. Medical management Acute management: Consider administering intravenous adenosine (6-18 mg bolus) for acute management of hemodynamically stable patients with focal AT. C Show 2 more Administer IV formulations of the following medications for acute management of hemodynamically stable patients with focal AT: -blockers diltiazem verapamil. B Show 3 more Ongoing management: https://web.pathway.md/diseases/recwf1PcPFxHl3j7a 1/2 6/29/23, 4:05 AM Focal atrial tachycardia Pathway Ongoing management: Consider initiating the following medications for the management of patients with focal AT if ablation is not desirable or feasible: -blockers nondihydropyridine CCBs (verapamil or diltiazem) in the absence of HFrEF propafenone or flecainide in the absence of structural or ischemic heart disease. C Show 2 more Consider initiating oral formulations of the following medications for ongoing management of patients with symptomatic focal AT: -blockers diltiazem verapamil. C Show 2 more 2. Therapeutic procedures Synchronized electrical cardioversion: Perform synchronized direct current cardioversion for acute management of hemodynamically unstable patients with focal AT. B Perform synchronized direct current cardioversion for acute management of hemodynamically stable patients with focal AT if drug therapy fails to convert or control the tachycardia. B Perform synchronized cardioversion for acute management of hemodynamically unstable patients with focal AT. B Catheter ablation: perform catheter ablation as an alternative to pharmacological therapy in symptomatic patients with focal AT. B References 1. Richard L Page, Jos A Joglar, Mary A Caldwell et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016 Apr 5;133 14):e471 505. Open 2. Josep Brugada, Demosthenes G Katritsis, Elena Arbelo et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology ESC . Eur Heart J. 2020 Feb 1;41 5 655 720. Open https://web.pathway.md/diseases/recwf1PcPFxHl3j7a 2/2