Multifocal Atrial Tachycardia

Created by team@ekgdx.com on Feb. 12, 2023

Let’s talk about multifocal atrial tachycardia (MAT).

MAT is a rapid, irregular atrial rhythm, characterized by at least three or more consecutive ectopic P waves with different morphology, due a multiple ectopic foci within the atria.

Criteria

  • ≥3 consecutive ectopic P waves with different morphology.
  • Atrial rate >100 bpm.
  • PP, PR and RR intervals are irregular.

Note the consecutive ectopic P waves with different morphology with irregular PP, RR and PR intervals and atrial rate >100 bpm. 

 

Same rhythm strip with graphical explanation. 

 

Note the different morphologies of the P waves (blue arrows) with irregular PP, PR and RR intervals.

 

Illustration. 

Possible causes: Commonly seen in patients with COPD or congestive heart failure, cronary artery disease, chronic renal failure, major surgery, electrolyte abnormalities including hypokalemia and hypomagnesemia, drugs such as aminophylline, theophylline and isoproterenol.

NOTE: MAT is a poor prognostic sign in the setting of an acute illness.

NOTE: MAT is the second most commonly misdiagnosed atrial arrhythmia. The key to diagnostic is to analyse lead V1 for the presence of atrial activity and lead II for the variable P waves morphology.

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References

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Thanks for joining us. 

Dr. Roig

Multifocal Atrial Tachycardia