eMedicine Specialties > Cardiology > Arrhythmias

Multifocal Atrial Tachycardia: Follow-up

Author: Neeraj Tandon, MB, BS, Chief, Cardiology Section, Associate Professor of Medicine, Medical Service, Overton Brooks Veterans Affairs Medical Center
Coauthor(s): Pratap Reddy, MD, Director, Electrophysiology Service, Professor, Department of Medicine, Section of Cardiology, Louisiana State University Health Sciences Center
Contributor Information and Disclosures

Updated: May 11, 2009

Follow-up

Further Inpatient Care

  • Further inpatient care is dictated by the underlying illness and treatment of this illness.
  • In patients with persistent and refractory multifocal atrial tachycardia (MAT), AV junctional ablation and permanent pacemaker implantation should be considered, both for symptomatic and hemodynamic improvement, and to prevent the development of tachycardia mediated cardiomyopathy.

Deterrence/Prevention

The best means of prevention of MAT is prevention of respiratory failure plus careful monitoring of all electrolyte disorders, namely, hypokalemia, hypomagnesemia, and drug therapy (mainly digoxin toxicity).

Complications

Potential complications include development of tachycardia-induced cardiomyopathy if the arrhythmia is persistent. Other complications include those due to drug therapy used to treat the arrhythmia.

Miscellaneous

Medicolegal Pitfalls

  • Clear differentiation of MAT from atrial fibrillation is very important because the treatment of atrial fibrillation differs from that of MAT.
  • MAT with aberration or preexisting bundle branch block may be misinterpreted as ventricular tachycardia.
  • Address underlying medical and metabolic issues.
 


More on Multifocal Atrial Tachycardia

Overview: Multifocal Atrial Tachycardia
Differential Diagnoses & Workup: Multifocal Atrial Tachycardia
Treatment & Medication: Multifocal Atrial Tachycardia
Follow-up: Multifocal Atrial Tachycardia
Multimedia: Multifocal Atrial Tachycardia
References
Further Reading
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References

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Keywords

MAT, chaotic atrial rhythm, chaotic atrial tachycardia, chaotic atrial mechanism, repetitive paroxysmal multifocal atrial tachycardia, intracellular calcium overload, catecholamine excess, phosphodiesterase inhibition, acidosis, hypoxemia, electrolyte imbalances associated with severe underlying illnesses, COPD, congestive heart failure, metabolic disorders, diabetes mellitus, hypokalemia, azotemia, postoperative infections, sepsis, pulmonary embolism, respiratory acidosis, coronary artery disease, valvular heart disease, hypomagnesemia, azotemia, multifocal atrial rhythm, multifocal atrial bradycardia, wandering atrial pacemaker

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Contributor Information and Disclosures

Author

Neeraj Tandon, MB, BS, Chief, Cardiology Section, Associate Professor of Medicine, Medical Service, Overton Brooks Veterans Affairs Medical Center
Neeraj Tandon, MB, BS is a member of the following medical societies: American College of Cardiology and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Coauthor(s)

Pratap Reddy, MD, Director, Electrophysiology Service, Professor, Department of Medicine, Section of Cardiology, Louisiana State University Health Sciences Center
Pratap Reddy, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Federation for Medical Research, American Heart Association, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Alan D Forker, MD, Professor of Medicine, Program Director of Cardiovascular Fellowship, University of Missouri at Kansas City School of Medicine; Director, Outpatient Lipid Diabetes Research Center, MidAmerica Heart Institute of St Luke's Hospital
Alan D Forker, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, American Society of Hypertension, and Phi Beta Kappa
Disclosure: Research Grant Grant/research funds Hospital contracts to do research; I am a hospital employee with no personal profit; Speakers Bureau Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Frank M Sheridan, MD, Cardiology, Providence Everett Medical Center
Frank M Sheridan, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, and Society for Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

CME Editor

Amer Suleman, MD, Consultant in Electrophysiology and Cardiovascular Medicine, Department of Internal Medicine, Division of Cardiology, Medical City Dallas Hospital
Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Chief Editor

Jeffrey N Rottman, MD, Professor of Medicine and Pharmacology, Director, Clinical Cardiac Electrophysiology Fellowship Program, Vanderbilt University School of Medicine; Chief, Department of Cardiology, Nashville Veterans Affairs Medical Center
Jeffrey N Rottman, MD is a member of the following medical societies: American Heart Association and North American Society of Pacing and Electrophysiology (NASPE)
Disclosure: Nothing to disclose.

 
 
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