A 69-year-old female presented to the emergency department with a two-hour history of persistent palpitations. An ECG showed a highly regular narrow QRS tachycardia with P waves. She was ultimately diagnosed with focal atrial tachycardia after an adenosine challenge. Focal atrial tachycardia is a regular, narrow complex, supraventricular tachycardic rhythm that is often paroxysmal and self-resolving. When this rhythm persists, it can eventually lead to tachycardia-induced cardiomyopathy. Narrow QRS complex tachycardia has a broad differential that encompasses many benign and dangerous rhythms. This report highlights the challenges and potential diagnostic pitfalls that can occur while trying to diagnose and evaluate tachydysrhythmias with presenting P-waves. We discuss the management strategies and propose a diagnostic algorithm to aid in the diagnosis of tachydysrhythmias.
Abstract
Case Reports
Journal Article
eng
42211596
Stahl, Brandon, et al. "Assessing Tachydysrhythmia when P-waves Are Present: Challenges and Pitfalls." Cureus, vol. 18, no. 4, 2026, pp. e107805.
Stahl B, Goldwag J, Wu G. Assessing Tachydysrhythmia When P-waves Are Present: Challenges and Pitfalls. Cureus. 2026;18(4):e107805.
Stahl, B., Goldwag, J., & Wu, G. (2026). Assessing Tachydysrhythmia When P-waves Are Present: Challenges and Pitfalls. Cureus, 18(4), e107805. https://doi.org/10.7759/cureus.107805
Stahl B, Goldwag J, Wu G. Assessing Tachydysrhythmia when P-waves Are Present: Challenges and Pitfalls. Cureus. 2026;18(4):e107805. PubMed PMID: 42211596.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Assessing Tachydysrhythmia When P-waves Are Present: Challenges and Pitfalls.
AU - Stahl,Brandon,
AU - Goldwag,Joshua,
AU - Wu,Gregory,
Y1 - 2026/04/27/
PY - 2026/04/27/accepted
PY - 2026/5/29/medline
PY - 2026/5/29/pubmed
PY - 2026/5/29/entrez
KW - cardiology
KW - focal atrial tachycardia
KW - heart palpitations
KW - narrow complex tachycardia
KW - supraventricular tachycardia (svt)
SP - e107805
EP - e107805
JF - Cureus
JO - Cureus
VL - 18
IS - 4
N2 - A 69-year-old female presented to the emergency department with a two-hour history of persistent palpitations. An ECG showed a highly regular narrow QRS tachycardia with P waves. She was ultimately diagnosed with focal atrial tachycardia after an adenosine challenge. Focal atrial tachycardia is a regular, narrow complex, supraventricular tachycardic rhythm that is often paroxysmal and self-resolving. When this rhythm persists, it can eventually lead to tachycardia-induced cardiomyopathy. Narrow QRS complex tachycardia has a broad differential that encompasses many benign and dangerous rhythms. This report highlights the challenges and potential diagnostic pitfalls that can occur while trying to diagnose and evaluate tachydysrhythmias with presenting P-waves. We discuss the management strategies and propose a diagnostic algorithm to aid in the diagnosis of tachydysrhythmias.
SN - 2168-8184
UR - https://www.unboundmedicine.com/prime/citation/42211596/Assessing_Tachydysrhythmia_When_P-waves_Are_Present:_Challenges_and_Pitfalls.
DB - PRIME
DP - Unbound Medicine
ER -
