ECG: Multifocal Atrial Tachycardia
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Transcript of ECG: Multifocal Atrial Tachycardia
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Prof.G.Sundaramurthy’s unit m7Dr.K.Bhargavi
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62 yr old male Smoker K/C/O COPD,CAD,SHT c/o-palpitations,respiratory distress,
giddiness Pale,b/l pedal edema PR-90/min; BP-110/70 mm Hg Cvs-S1S2 + ; Rs- b/l crepts
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12 lead ecg showing Rate > 100 Rhythm-irregular P waves of >3 different morphologies Varying P-P,P-R,R-R intervals LVH pattern PRWP V1 – V3.
MULTIFOCAL ATRIAL TACHYCARDIA
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Cardiac arrythmia Wandering atrial pacemaker The electrical impulse is generated at a
different focus within the atria of the heart each time.
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Decompensated chronic lung disease Congestive heart failure Sepsis Myocardial infarction Pneumonia Pulmonary embolism Hypokalemia Methylxanthine toxicity
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Palpitations Shortness of breath Chest pain Lightheadedness Syncopal episodes
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ECG Characteristics: Discrete P waves with at least 3different morphologies. Absence of one dominant atrial
pacemaker Atrial rate > 100 bpm.
The PP, PR, and RR intervals all vary.
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Antiarrhythmics verapamil Magnesium sulfate potassium
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Other atrial arrhythmias
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atrial rate of 250-350 bpm large reentrant circuit Negative sawtooth flutter waves in leads II,
III, and AVF. AV conduction most commonly is 2:1, which yields a ventricular rate of approximately 150 bpm
ischemic heart disease, myocardial infarction, cardiomyopathy, myocarditis, pulmonary embolus or chest trauma
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chaotic atrial depolarization The atria contract irregularly and very
rapidly producing variable R-R intervals No regular P waves are identifiable and the
baseline is undulating. rheumatic heart disease, hypertension,
ischemic heart disease, pericarditis, thyrotoxicosis, alcohol intoxication, mitral valve prolapse, and digitalis toxicity
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Irregular rhythm. P waves change shape as pacemaker location varies. Rate under 100/minute QRS- NORMAL PSVT
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Same as P.A.T. but only every second (or more) P’ wave produces a QRS.
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P waveusually have a different morphology than sinus P waves because they originate from an ectopic pacemaker
QRSnormal Conductionnormal, however the ectopic
beats may have a different P-R interval. RhythmPAC's occur early in the cycle and
they usually do not have a complete compensatory pause.
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a pause in the normal cardiac rhythm due to a momentary failure of the sinus node to initiate an impulse, lasting for an interval that is not an exact multiple of the normal cardiac cycle.
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