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Multifocal atrial tachycardia

K Wang, B L Goldfarb, F L Gobel

    Archives of Internal Medicine
    |February 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Multifocal atrial tachycardia (MAT) is a serious arrhythmia often seen in patients with acute respiratory distress, but it is not the primary cause of death. Propranolol effectively slowed the atrial rate in patients with MAT.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Critical Care Medicine

    Background:

    • Multifocal atrial tachycardia (MAT) is an uncommon supraventricular tachyarrhythmia.
    • MAT is often associated with severe underlying medical conditions, particularly respiratory disease.
    • The clinical significance and management of MAT remain areas of interest.

    Purpose of the Study:

    • To describe the clinical characteristics and outcomes of patients with MAT.
    • To evaluate the efficacy of various antiarrhythmic agents in treating MAT.
    • To determine the relationship between MAT and other atrial arrhythmias.

    Main Methods:

    • Retrospective analysis of 41 patients diagnosed with MAT.
    • Review of patient demographics, clinical presentation, underlying conditions, and treatment regimens.

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  • Assessment of treatment response, including heart rate control and mortality.

    • Main Results:

    • MAT was observed in 41 patients, with 35 in acute respiratory distress.
    • Hospital mortality was 37%, reflecting the severity of underlying conditions, not the arrhythmia itself.
    • MAT preceded or followed atrial fibrillation/flutter in 46% of cases.
    • Digitalis and several antiarrhythmic drugs (quinidine, procainamide, lidocaine, phenytoin) were ineffective in controlling MAT or slowing ventricular response.
    • Propranolol hydrochloride effectively slowed the atrial rate in all seven patients who received it.
    • Electrocardioversion was unsuccessful in one patient.

    Conclusions:

    • MAT is a marker of severe illness and is not the primary cause of death.
    • Conventional antiarrhythmic drugs and digitalis are generally ineffective for MAT.
    • Propranolol is an effective agent for controlling the atrial rate in MAT.
    • MAT can mimic other arrhythmias like atrial fibrillation, especially when P-waves are inconspicuous.