Multifocal atrial tachycardia
| Multifocal atrial tachycardia | |
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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 (MAT) or also called chaotic atrial tachycardia is a cardiac arrhythmia, specifically a type of supraventricular tachycardia (rate exceeding 100 beats per minute). This is characterized by 3 or more different P wave shapes or contour, variable PP, PR and RR intervals. Most P waves are conducted to the ventricles but some are not. Some R waves are aberrantly conducted.This variability makes it look irregular on the surface ECG and often misinterpreted as atrial fibrillation.
A rhythm with same the ECG characteristics but at a slow rate is called multifocal atrial rhythm (MAR).
It can be seen among elderly patients with COPD and CHF and eventually develop into atrial fibrillation.
Causes
Multifocal atrial tachycardia usually results from an underlying medical condition such as COPD, chronic renal failure, pulmonary embolism, electrolyte imbalance, and many other conditions.
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Aminophylline toxicity
- Congestive heart failure
- Hypokalemia
- Hypoxia
- Myocardial infarction
- Pulmonary embolism
- Sepsis
Common Causes
- Chronic obstructive pulmonary disease
- Chronic renal failure
- Congestive heart failure
- Diabetes mellitus
- Hypokalemia
- Hypoxia
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
- Sepsis
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 | Aminophylline |
| 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
Examples
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