Document Detail

Recognition and treatment of multifocal atrial tachycardia: a critical review.
MedLine Citation:
PMID:  8040593     Owner:  NLM     Status:  MEDLINE    
Multifocal atrial tachycardia (MAT) is an uncommon but clinically important tachydysrhythmia that is usually seen in the setting of severe cardiopulmonary illness. Diagnostic criteria include the presence of at least three different, nonsinus P waves in the same lead; an atrial rate greater than 100 beats per minute; and an isoelectric baseline between P waves. MAT is often difficult to differentiate from atrial fibrillation. The pathogenesis of MAT is unknown; however, it is probably incited by "triggered" electrical activity, a form of abnormal automaticity. This electrophysiologic model has led to several small, uncontrolled clinical trials using calcium channel and beta-adrenergic blocking agents, specifically verapamil and metropolol. None of these trials meets rigorous methodologic standards, and all exclude unstable patients who are at greatest risk for hemodynamic compromise from the tachycardia. Treatment of MAT should first be directed at potential predisposing factors, such as hypoxia, congestive heart failure, and theophylline toxicity. Pharmacologic treatment includes intravenous metoprolol or verapamil; in published reports both agents have been well tolerated and have controlled the heart rate in a majority of patients.
M Schwartz; D Rodman; S R Lowenstein
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  12     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:    1994 May-Jun
Date Detail:
Created Date:  1994-08-25     Completed Date:  1994-08-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  353-60     Citation Subset:  IM    
Division of Pulmonary Sciences, University of Colorado Health Sciences Center, Denver 80262.
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MeSH Terms
Clinical Trials as Topic
Diagnosis, Differential
Heart Conduction System / physiopathology
Magnesium / therapeutic use
Metoprolol / therapeutic use
Tachycardia / diagnosis,  drug therapy*,  physiopathology*
Verapamil / therapeutic use
Reg. No./Substance:
37350-58-6/Metoprolol; 52-53-9/Verapamil; 7439-95-4/Magnesium

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