Difference between revisions of "Multifocal atrial tachycardia"

(Clinical Features)
 
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==Background==
 
==Background==
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*Multiple (3 or more) ectopic foci in the atria causing an irregular atrial tachycardia
 +
*Increased automaticity due to causes listed below
  
 
===Causes===
 
===Causes===
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*[[CHF]]
 
*[[CHF]]
 
*[[Sepsis]]
 
*[[Sepsis]]
*Methylxanthine toxicity
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*Methylxanthine toxicity / [[Theophylline toxicity]]
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*[[Electrolyte abnormalities]]
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*Other associations
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**Valvular heart disease
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**[[DM]]
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**[[Acute renal failure]]
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**Postoperative state
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**[[Pulmonary embolism]]
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**[[Pneumonia]]
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**[[Anemia]]
  
 
==Clinical Features==
 
==Clinical Features==
[[Multifocal atrial tachycardia - MAT.png|thumb|Multifocal atrial tachycardia]]
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*[[Palpitations]]
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*[[Dyspnea]]
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*[[Chest pain]]
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*Presyncope/[[syncope]]
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[[File:Multifocal atrial tachycardia - MAT.png|thumb|Multifocal atrial tachycardia]]
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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{{Tachycardia (narrow) DDX}}
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{{Palpitations DDX}}
  
 
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==Evaluation==
==Workup==
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*[[ECG]]
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**Irregular tachycardia (>100 bpm)
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**At least 3 distinct p wave morphologies
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**No dominant pacemaker site
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*BMP, Magnesium
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*Hemoglobin/hematocrit
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*Consider infectious disease work up
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*Consider [[ABG]]/[[VBG]]
  
 
==Management==
 
==Management==
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*Treat underlying cause
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*Replace [[magnesium]]
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*Replace [[potassium]]
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*Increased AV nodal activity is unlikely to be effective
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**[[Vagal maneuvers]] and [[adenosine]] may help reveal underlying rhythm/p-waves
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**Can consider [[beta-blocker]] or [[calcium channel blocker]] in hemodynamically stable patient
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***Use beta-blockers cautiously in patients with pulmonary disease
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*[[Cardioversion]] ''not'' definitive
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**MAT likely to recur if underlying etiology not addressed
  
 
==Disposition==
 
==Disposition==
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*Disposition depends on underlying illness, but often requires admission due to illness severity
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*Poor prognostic sign when MAT develops during hospitalization or acute illness
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**60% in-hospital mortality
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***Due to illness, not arrhythmia
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**Mean survival around 1 year
  
 
==See Also==
 
==See Also==
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==External Links==
 
==External Links==
  
==Sources==
+
==References==
 
<references/>
 
<references/>
 +
 +
[[Category:Cardiology]]

Latest revision as of 15:46, 25 September 2019

Background

  • Multiple (3 or more) ectopic foci in the atria causing an irregular atrial tachycardia
  • Increased automaticity due to causes listed below

Causes

Clinical Features

Multifocal atrial tachycardia

Differential Diagnosis

Narrow-complex tachycardia

Palpitations

Evaluation

  • ECG
    • Irregular tachycardia (>100 bpm)
    • At least 3 distinct p wave morphologies
    • No dominant pacemaker site
  • BMP, Magnesium
  • Hemoglobin/hematocrit
  • Consider infectious disease work up
  • Consider ABG/VBG

Management

Disposition

  • Disposition depends on underlying illness, but often requires admission due to illness severity
  • Poor prognostic sign when MAT develops during hospitalization or acute illness
    • 60% in-hospital mortality
      • Due to illness, not arrhythmia
    • Mean survival around 1 year

See Also

External Links

References