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Multifocal Atrial Tachycardia

Multifocal Atrial Tachycardia (MAT)

Definition

  • ≥3 different P wave morphologies prior to QRSs, Irregularly irregular rhythm
  • HR typically between 100-150
  • Multiple discrete p wave morphologies (multiple discrete p waves) with increased automaticity irritated by increased atrial pressures or hypoxia
  • Pneumonia, Hypoxemia, Catecholamine Surge (Sepsis), Pneumonia, hypomagnesemia, theophylline

Clinical Context

  • Clear iselectric intervals between p waves, and the atrial rate is slower
  • Usually caused by severe COPD or acute illness
  • Pulmonary hypertension, coronary disease, valvular disease, hypomagnesemia, theophylline

Symptoms

  • Typically asymptomatic

Treatment

  • Treat Underlying Condition (generally slower)
    • CCBs/Metoprolol long-term
    • Acute Exacerbation: IV Metoprolol/Verapamil (CCBs)
    • Amiodarone/Ablation/Cardioversion do work in MAT
  • Electrolyte management
    • Correct magnesium deficiency (check and replicate)