Multifocal Atrial Tachycardia Flashcards
What is the characteristic ECG finding of multifocal atrial tachycardia (MAT)?
Distinct P waves of at least three different morphologies, irregular R-R intervals, and an atrial rate >100/min.
Which patient population is most commonly affected by multifocal atrial tachycardia (MAT)?
Elderly patients (>70 years), especially those with chronic obstructive pulmonary disease (COPD) or other pulmonary disorders.
What are the clinical findings commonly associated with multifocal atrial tachycardia (MAT)?
Rapid, irregular pulse; symptoms of the underlying illness, such as cough, wheezing, or shortness of breath.
What are the most common causes of multifocal atrial tachycardia (MAT)?
- Exacerbation of pulmonary diseases (COPD)
- Electrolyte disturbances (e.g., hypokalemia)
- Catecholamine surge due to an underlying illness or sepsis
How is the atrial rate in multifocal atrial tachycardia (MAT) different from wandering atrial pacemaker?
The atrial rate in MAT is >100/min, while it is <100/min in wandering atrial pacemaker.
What is the initial treatment for multifocal atrial tachycardia (MAT)?
Management of the underlying inciting illness, such as COPD exacerbation, with bronchodilators, systemic corticosteroids, and oxygen therapy. Some patients may require forced/noninvasive oxygen therapy.
How does noninvasive ventilation help resolve multifocal atrial tachycardia (MAT)?
It alleviates respiratory distress, reduces catecholamine surge, and improves oxygenation, which helps resolve the arrhythmia.
Why is synchronized cardioversion not appropriate for managing MAT?
Synchronized cardioversion is reserved for hemodynamically unstable supraventricular tachycardias, but MAT rarely causes hemodynamic instability.
What is the role of systemic corticosteroids in treating MAT?
They reduce inflammation in the context of pulmonary exacerbation, addressing the underlying cause of MAT.
What is the role of non-dihydropyridine calcium channel blockers (e.g., diltiazem) in MAT management?
They can be used to control the rapid ventricular rate but do not address the underlying cause of MAT, therefore this is typically used as a second-line treatment approach used for refractory MAT.
