Changing P Wave Morphology- A Focus on Multifocal Atrial Tachycardia

Multifocal atrial tachycardia is an uncommon atrial tachyarrhythmia. It usually occurs in the elderly and critically ill patients, frequently associated with underlying chronic obstructive pulmonary disease. It is uncommon for loss of atrioventricular conduction of each P wave and as a result, multifocal atrial tachycardia should be distinguished from atrial fibrillation. Multifocal atrial tachycardia, wandering atrial pacemaker, atrial fibrillation, and atrial flutter with variable conduction are the irregularly irregular rhythms commonly encountered on an electrocardiogram. It is important to recognize the difference between these as the management differs significantly. Treatment for multifocal atrial tachycardia is directed at the inciting disturbance. Maintaining electrolyte balance especially plasma potassium and magnesium levels may prevent the occurrence of multifocal atrial tachycardia.