Multifocal atrial tachycardia: Difference between revisions

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Revision as of 15:32, 22 August 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: MAT;

Overview

Multifocal atrial tachycardia is a cardiac arrhythmia, specifically a type of supraventricular tachycardia. It is characterized by an electrocardiogram (ECG) strip with 3 or more P-waves of variable morphology and varying P-R intervals, plus tachycardia, which is a heart rate exceeding 100 beats per minute.

The P-waves and P-R intervals are variable due to a phenomenon called wandering atrial pacemaker (WAP). The electrical impulse is generated at a different focus within the atria of the heart each time. WAP is positive once the heart generates at least three different P-wave formations from the same ECG lead. Then, if the heart rate exceeds 100 beats per minute, the phenomenon is called multifocal atrial tachycardia. It is mostly common in patients with lung disorders, but it can be occur after acute MI, hypokalemia, and hypomagnesemia. It is sometimes associated with digitalis toxicity in patients with heart disease. Its rate can be reduced by administering verapamil.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	Congestive heart failure, myocardial infarction, valvular heart disease
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Aminophylline, Isoproterenol, theophylline
Ear Nose Throat	No underlying causes
Endocrine	Diabetes mellitus
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Postoperative complication
Infectious Disease	Pneumonia, sepsis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	Lung cancer
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Chronic obstructive pulmonary disease, hypoxia, lung cancer, pneumonia, pulmonary embolism
Renal/Electrolyte	Chronic renal failure, hypokalemia, hypomagnesemia
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Diagnosis

Electrocardiography

There are P waves of varying morphology from at least three different foci
There is absence of one dominant atrial pacemaker
Variable PP intervals, RR intervals, and PR intervals
Atrial rate is above 100 beats per minute (bpm)
Can be mistaken for atrial fibrillation if the p waves are of low amplitude
High incidence in the elderly and in those with COPD

References

Additional resources

ECGpedia: Course for interpretation of ECG

Examples

Template:WikiDoc Sources

@@ Line 27: / Line 27: @@
 ==Causes==
+===Life Threatening Causes===
+Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
+===Common Causes===
+===Causes by Organ System===
+{|style="width:80%; height:100px" border="1"
+|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
+|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Congestive heart failure]], [[myocardial infarction]], [[valvular heart disease]]
+|-
+|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dental'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dermatologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Drug Side Effect'''
+|bgcolor="Beige"| [[Aminophylline]], [[Isoproterenol]], [[theophylline]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Ear Nose Throat'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Endocrine'''
+|bgcolor="Beige"| [[Diabetes mellitus]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Environmental'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Gastroenterologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Genetic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Hematologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Iatrogenic'''
+|bgcolor="Beige"| [[Postoperative complication]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Infectious Disease'''
+|bgcolor="Beige"| [[Pneumonia]], [[sepsis]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Musculoskeletal/Orthopedic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Neurologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Nutritional/Metabolic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Obstetric/Gynecologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Oncologic'''
+|bgcolor="Beige"| [[Lung cancer]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Ophthalmologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Overdose/Toxicity'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Psychiatric'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Pulmonary'''
+|bgcolor="Beige"| [[Chronic obstructive pulmonary disease]], [[hypoxia]], [[lung cancer]], [[pneumonia]], [[pulmonary embolism]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Renal/Electrolyte'''
+|bgcolor="Beige"| [[Chronic renal failure]], [[hypokalemia]], [[hypomagnesemia]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Rheumatology/Immunology/Allergy'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Sexual'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Trauma'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Urologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Miscellaneous'''
+|bgcolor="Beige"| No underlying causes
+|-
+|}
+===Causes in Alphabetical Order===
+{{col-begin|width=80%}}
+{{col-break|width=33%}}
 *[[Aminophylline]]
-*[[Pneumonia]]
 *[[Chronic obstructive pulmonary disease]]
 *[[Chronic renal failure]]
@@ Line 40: / Line 161: @@
 *[[Lung cancer]]
 *[[Myocardial infarction]]
+*[[Pneumonia]]
 *[[Postoperative complication]]
 *[[Pulmonary embolism]]
 *[[Sepsis]]
 *[[Valvular heart disease]]
+{{col-end}}
 ==Diagnosis==