Multifocal atrial tachycardia

Multifocal atrial tachycardia (MAT) is a type of tachycardia characterized by multiple P wave morphologies and irregular P-P intervals. It is often associated with severe underlying medical conditions, particularly lung disease and cardiac disease.

Epidemiology

MAT is most commonly seen in elderly patients with severe pulmonary disease. It is also associated with coronary artery disease, diabetes, sepsis, and following surgery.

Pathophysiology

The exact mechanism of MAT is not well understood. It is thought to be due to enhanced automaticity or triggered activity in multiple atrial foci. The irregular rhythm is due to the random discharge of these multiple foci.

Clinical Features

Patients with MAT may present with palpitations, dyspnea, or syncope. However, many patients are asymptomatic and MAT is discovered incidentally on electrocardiogram (ECG).

Diagnosis

The diagnosis of MAT is made on ECG. The characteristic findings include an irregularly irregular rhythm, heart rate >100 beats per minute, and at least three different P wave morphologies.

Treatment

The treatment of MAT is primarily directed at the underlying condition. In some cases, rate control with calcium channel blockers or beta blockers may be necessary.

Prognosis

The prognosis of MAT is generally poor, due to the severity of the underlying conditions. However, with appropriate treatment of the underlying condition, the prognosis can be improved.

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