Multifocal Atrial Tachycardia : Causes, Symptoms, Diagnosis, Differential Diagnosis, Treatment

A heart arrhythmia known as multifocal atrial tachycardia (MAT) is brought on by several areas of conflicting atrial activity. An irregular atrial rate of more than 100 beats per minute (bpm) distinguishes it. At least three morphologically distinct P waves, irregular P-P intervals, and an isoelectric baseline between the P waves are all signs of well-organized atrial activity.

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What are the causes of Multifocal Atrial Tachycardia?

The average age of those who experience MAT is over 70. However, it can also occur in adolescents or young adults on occasion. Men and those with one or more underlying health issues are more likely to experience it. These issues could involve:

• Persistent lung disease
• Failure to breathe quickly
• Cardiovascular disease
• Enlarged heart disease
• Diabetes
• Persistent renal failure
• Pneumonia Sepsis
• COPD
• Theophylline toxicity

What are the symptoms of Multifocal Atrial Tachycardia?

Most persons with multifocal atrial tachycardia don't have any symptoms. However, you can also be experiencing signs of the underlying issue. Some people might not show any symptoms. When they appear, symptoms may include:

• Having a tight chest
• Fainting
• Lightheadedness
• Palpitations: the sensation that one's heart is pounding abnormally or excessively quickly.
• Respiration: difficulty respiration difficulty. Breathing is uncomfortable and Having the impression that you are not receiving enough air 

Additional signs and symptoms of this condition include:

• Trouble breathing while lying down
• Dizziness

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Diagnosis of Multifocal Atrial Tachycardia

A practitioner just needs to perform an electrocardiogram (EKG) to diagnose MAT.

After determining that you have multifocal atrial tachycardia, a doctor might suggest:

• Chest X-ray.
• A blood test.
• An echocardiography.

Differential Diagnosis of Multifocal Atrial Tachycardia

• Electrocardiogram with atrial fibrillation (irregularly irregular heartbeat without separate P waves before each QRS complex) as opposed to MAT
• A distinctive characteristic of atrial flutter
• The waves on an ECG have a "sawtooth" look and a rapid regular rhythm.
• Palpitations, ectopic P-waves, and premature atrial contractions with an unexpected beat

Treatment of Multifocal Atrial Tachycardia

Your arrhythmia may be treated with multifocal atrial tachycardia by:

• D-C shock: Usually not recommended in this patient as Heart is in a hypoxic state and there is an amount of theophylline or cytokine present. So, when we give DC shock the rhythm gets normal but after some time it gets abnormal.So, we don’t give DC shock frequently.
• Verapamil: Verapamil acts on the AV node it slows down the conduction and causes stabilization of the heart.The dizziness and palpitation component is managed.
• Metoprolol (Beta blocker)
• Amiodarone: it has a membrane-stabilizing effect but It has its own toxicity. So, it cannot be prescribed for a long time.
• Treatment of the cause: Treatment of COPD with the  Low-flow oxygen supplementation, Increased the dose of LAMA and addition of  inhaled corticosteroids.Management of the COPD to prevent the recurrence of MAT.

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