Atrial tachycardia multifocal

Automatic atrial tachycardias such as multifocal atrial tachycardia appear to arise from supraventricular foci with enhanced automatic properties. Severe pulmonary disease is the underlying precipitating disorder in 60% to 80% of patients. 

Levine JH, Michael JR, Guarnieri T. Multifocal atrial tachycardia a toxic effect of theophylline. Lancet 1985 1(8419) 12-14. 

Amiodarone is indicated for the suppression and prevention of documented life-threatening, recurrent, ventricular tachycardia or fibrillation when other agents have failed. Amiodarone is also used in the management of supraventricular tachyarrhythmias including paroxysmal atrial fibrillation and atrial flutter, ectopic or multifocal atrial tachycardia, junctional tachycardia, and paroxysmal reentrant supraventricular tachycardia when other agents have failed to suppress or prevent their recurrence. Amiodarone has also been used to treat wide-complex tachycardia of uncertain mechanism. 

Automatic atrial tachycardias such as multifocal atrial tachycardia appear to arise from supraventricular foci that have enhanced automatic properties. It is presumed that multifocal atrial tachycardia is the result of multiple ectopic atrial pacemakers, which account for the variable and differing P-wave morphology. In unifocal atrial tachycardia (sometimes referred to as ectopic atrial tachycardia), a single P-wave morphology different from that of sinus rhythm is recorded. In either case, the underlying, precipitating disorder present in the major-... 

McCord J, Borzak S. Multifocal atrial tachycardia. Chest 1998 113 203— 209. 

Levine JH, Michael JR, Guamier T. Treatment of multifocal atrial tachycardia with verapamil. N Engl J Med 1985 312 21-25. 

In theophyUine acute overdose patients are more likely to exhibit hypotension, hypokalemia, and/or metaboUc acidosis than are patients receiving chronic overmedication. Patients suffering chronic overmedication can develop seizures and serious arrhythmias with serum concentrations of 28-70 /xg/mL. Cardiac arrhythmias include atrial fibriUation or atrial flutter, multifocal atrial tachycardia, sinus tachycardia, supraventricular tachycardia and premature ventricular contractions with hemodynamic instabUity. 

Theophylline Multifocal atrial tachycardia Withdraw theophyUine Verapamil Often in advanced lung disease... 

Factors that commonly precipitate cardiac arrhythmias include hypoxia, electrolyte disturbances (especially hypokalemia), myocardial ischemia, and certain drugs (Table 34-1). For example, theophylline can cause multifocal atrial tachycardia, while torsades de pointes can arise not only during therapy with action potential-prolonging antiarrhythmics but also with other drugs, including erythromycin (see Chapter 46) pentamidine (see Chapter 40) and some antipsy-chotics, notably thioridazine (see Chapter 18). 

Quinidine (e.g., Cin-Quin) Depresses automaticity of ectopic foci. Siows conduction veiocity in atria His-Purkinje ceils. Prolongs refractory period throughout heart (except nodes) and accessory pathways. Has anticholinergic effects which may actuaiiy enhance A-V conduction in patients with rapid atrial depolarization. Multifocal atrial tachycardia, premature atrial depolarization, premature ventricular depolarization, atrial fibrillation (these result from increased automaticity of ectopic foci), and ventricular tachycardia. Torsades de pointes (recurrent, temporary arrhythmia), increases ventricle response to atrial tachyarrhythmia, nausea, vomiting, diarrhea, hypersensitivity, cinchonism, thrombocytopenic purpura. 

Multifocal atrial tachycardia, atrial flutter atrial fibrillation A-V reentry, Wolff-Parkinson-White... 

Probable atrial fibrillation or possible atrial flutter or multifocal atrial tachycardia... 

A 3-year-old toddler developed multifocal atrial tachycardia following an iatrogenic overdose of adrenaline accidentally administered (i.v). His ECG showed wandering atrial pacemaker (P-waves with different origins and configurations) that persisted for at least 1 year. This event... 

This is essentially the same as Multifocal Atrial Tachycardia but with a rate below 100 BPM. 

Multifocal atrial tachycardia (MAT, or chaotic atrial rhythm). 

May be difficult to differentiate atrial fibrillation from multifocal atrial tachycardia and junctional rhythm. 

To help you decide whether a rhythm is atrial fibrillation or the similar multifocal atrial tachycardia (MAT), focus on the P waves and the atrial and ventricular rhythms. You may find it helpful to look at a rhythm strip that s longer than 6 seconds. 

Multifocal atrial tachycardia II, V, Vg, MCL, MCLg (with aberrancy)... 

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