Atrial Rhythms

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    91 year old female who is a smoker.

    91 year old female who is a smoker.

    Questions

    Question 1: What causes the difference in P wave morphology in wandering multifocal atrial tachycardia? 

    Question 2: What is the difference between multifocal atrial tachycardia and wandering atrial pacemaker? 

    Question 3: What type of patients develop multifocal atrial tachycardia? 

    Question 4: What are some treatment options for this patient's rhythm?

    Key findings

    -MAT

    -PVCs

    Coding for Boards

    -Multifocal atrial tachycardia

    Answers

    Question 1: The different P wave morphologies occur because they are originating from different areas of the atrium.

    Question 2:  If the mean heart rate is less than 100 bpm, the rhythm iscalled wandering atrial pacemaker. When the heart rate exceeds 100 it is called multifocal atrial tachycardia.

    Question 3: MAT almost always occurs in patients with lung disease, often during an acute exacerbation.

    Question 4: Verapamil and IV magnesium