ECG Quiz 44 Answer

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Multifocal atrial tachycardia (n=1).

Q: What does this research mean for the field?

Multifocal atrial tachycardia can present as an irregular wide-complex tachycardia when combined with bundle branch block, is frequently precipitated by severe chronic obstructive pulmonary disease, and is best managed by treating the underlying pulmonary condition rather than direct antiarrhythmic therapy. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Ashley Chin; Rob Scott Millar

doi:10.24170/13-4-1589

February 23, 2017SA HeartOpen Access

ECG Quiz 44 Answer

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Key result

Multiple distinct P-wave morphologies confirm multifocal atrial tachycardia in severe COPD.

n=1

Why the study?

Multifocal atrial tachycardia (MAT) is often misdiagnosed as atrial fibrillation, and its association with severe chronic obstructive pulmonary disease (COPD) and prognosis requires clarification.

Key Points

Determine the underlying etiology and accurate diagnosis of an irregular wide-complex tachycardia in a patient with complex cardiopulmonary disease.
Analyzed 12-lead electrocardiogram tracings focusing on QRS morphology in leads V1 and V6, limb lead axis, and P-wave morphology in rhythm strip lead II.
Evaluated pulmonary function test metrics and reviewed cardiac surgical history.
ECG revealed an irregular wide-complex tachycardia at a ventricular rate of 114bpm with 6 distinct P-wave morphologies, right bundle branch block, and left anterior fascicular block with a QRS axis of -75 degrees.
Identified multifocal atrial tachycardia secondary to severe chronic obstructive pulmonary disease, with pulmonary function showing FEV1 600ml, FVC 1 700ml, and FEV1/FVC 35%.
Noted that multifocal atrial tachycardia is typically transient and managed by addressing hypoxaemia and lung disease rather than antiarrhythmic agents or cardioversion.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A single male patient with severe chronic obstructive pulmonary disease and a history of arrhythmogenic right ventricular cardiomyopathy presenting with multifocal atrial tachycardia.

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Implication

Multifocal atrial tachycardia can mimic atrial fibrillation and is typically an epiphenomenon of underlying pulmonary disease like severe COPD.

Abstract

ECG Quiz 44 Answers.

Discussion

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Cite This Study

Chin et al. (2017) conducted a case report in Multifocal atrial tachycardia (n=1). An irregularly irregular rhythm on ECG with multiple distinct P wave morphologies confirmed multifocal atrial tachycardia in a patient with severe COPD.

synapsesocial.com/papers/6ac19d70aeea5716e8c6c61a https://doi.org/10.24170/13-4-1589

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ECG Quiz 44 Answer

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

ECG Quiz 44 Answer

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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