Multifocal Atrial Tachycardia
Posted by dkwinter


  • exacerbation of pulmonary disease (e.g. COPD)
  • electrolyte disturbance
  • catecholamine surge (e.g. sepsis)


Common history

  • elderly patients with an acute exacerbation of underlying pulmonary disease (e.g. COPD)
  • symptoms related to etiology (e.g. cough, wheeze and shortness of breath)


Clinical findings

  • typically asymptomatic
  • rapid, irregular pulse
  • at least 3 distinct P wave morphologies
  • atrial rate >100/min



  • treat the underlying etiology, commonly:
    • COPD exacerbation
      • supplemental oxygen (=/- ventilation)
      • steroids
      • antibiotics
  • only if absolutely necessary, venticular rate can be controlled with
    • nondihydropyridine calcium channel blockers (e.g. verapamil, diltiazem)
    • beta-blockers