Multifocal atrial tachycardia

Atrial tachycardia (AT) is a type of abnormal heart rhythm, or What happens during atrial tachycardia? A normal heartbeat begins with an electrical impulse from the sinus node, a single point in the heart's right atrium (right upper chamber). During atrial tachycardia, an electrical impulse outside the sinus node fires repeatedly, often due to a short circuit — a circular electrical pathway. Electricity circles the atria again and again, causing the upper chambers to contract more than 100 times per minute. (A An arrhythmia centered in the upper chambers of the heart is called a supraventricular tachycardia (SVT) — literally, fast "heartbeat above the ventricles" (lower chambers). Atrial tachycardia usually occurs for brief periods and starts and stops spontaneously. That's called paroxysmal AT. If it continues, it is called persistent AT What are the symptoms of atrial tachycardia? Atrial tachycardia may cause no symptoms at all or may cause any of the following: • Palpitations (a fluttering in the chest) • Fainting • Chest pain • Shortness of breath • Fatigue • Heart failure What causes atrial tachycardia? Atrial tachycardia occurs most commonly in elderly patients and those with other types of heart disease, though it occasionally appears in children, younger people and those with healthy hearts. Causes include: • A "stretched" atrium resulting from high blood pressure ( • A previous heart attack • Excessive use of alcohol, cocaine and other stimulants • An "irritable f...

Catherine Ellen Poindexter Professor of Cardiology, Professor of Medicine, Director, Cardiac Arrhythmia Services, Director, Electrophysiology Laboratory, Director, Johns Hopkins ARVD/C Program, Member, Miller-Coulson Academy of Clinical Excellence, Sheikh Zayed Tower - Room 7125 R, 1800 Orleans Street, Baltimore, MD, Hugh Calkins, MD FHRS FACC FAHA FESC, The 2019 ESC Guidelines for the Management of Patients with Supraventricular Tachycardia: What you need to know about the 2019 ESC Guidelines are discussed by Professor Hugh Calkins, Member of the Guideline Writing Group, European Heart Journal, Volume 40, Issue 47, 14 December 2019, Pages 3812–3813, Dr Demos Katritsis and his writing group have produced an important new guidelines document on the management of all types of supraventricular tachycardias (SVTs). The one exception is atrial fibrillation (AF), which is covered in the 2016 European Society of Cardiology (ESC) AF guidelines. This document is a complete rewrite of the 2003 SVT guidelines, which were published as a joint document with the American Heart Association and the American College of Cardiology. In this brief article, I will highlight the most important features of the new 2019 ESC SVT Guidelines. The first important change in the 2019 ESC SVT guideline, when compared with the prior guideline published 16 years earlier is that the Class and level of recommendations supporting catheter ablation for chronic treatment of all types of SVTs have been increase...

Multifocal atrial When your This happens because the signals that control your heartbeat aren’t working right. In this type of tachycardia, those irregular signals come from three or more places in the heart’s upper chambers. That’s where MAT gets its name. “Multifocal” means having more than one focus and “atrial” refers to the heart’s two upper chambers, called atria. Causes Doctors don’t know exactly what causes MAT. Part of the reason it’s poorly understood is that MAT isn’t a very common type of arrhythmia. MAT usually happens in older people, with an average age of 70. But it sometimes also happens in children or young adults. It’s more common in men and in people with one or more other health problems. These problems may include: • Chronic • Acute respiratory failure • • • • Chronic • • Sometimes MAT happens in people after major surgery. It also can happen in people who have an imbalance of Diagnosis Sometimes people with MAT have these signs: • • Shortness of breath • • A feeling of being lightheaded • Blacking out But many times, people with MAT don’t feel like their heart isn’t beating normally or notice other signs. Doctors often find it unexpectedly in people with other health problems. It’s hard to tell from a Treatment MAT itself isn’t usually life-threatening. But if you have it, it’s likely that you have other serious health conditions -- and those can be very serious. In most cases, the best way to treat MAT is to treat the other health problems. Once tho...

Multifocal Atrial Tachycardia (MAT) Overview • A rapid, irregular atrial rhythm arising from multiple ectopic foci within the atria. • Most commonly seen in patients with severe • It is typically a transitional rhythm between frequent premature atrial complexes (PACs) and atrial flutter / fibrillation. AKA “Chaotic atrial tachycardia” Electrocardiographic Features • Heart rate > 100 bpm (usually 100-150 bpm; may be as high as 250 bpm). • Irregularly irregular rhythm with varying PP, PR and RR intervals. • At least 3 distinct P-wave morphologies in the same lead. • Isoelectric baseline between P-waves (i.e. no flutter waves). • Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent PACs). • Some P waves may be nonconducted; others may be aberrantly conducted to the ventricles. There may be additional Clinical Relevance • Usually occurs in seriously ill elderly patients with respiratory failure (e.g. exacerbation of COPD / CHF). • Tends to resolve following treatment of the underlying disorder. • The development of MAT during an acute illness is a poor prognostic sign, associated with a 60% in-hospital mortality and mean survival of just over a year. Death occurs due to the underlying illness; not the arrhythmia itself. Mechanism Arises due to a combination of factors that are present in hospitalised patients with acute-on-chronic respiratory failure: • Right atrial dilatation (from cor pulmonale) • Increased sympathetic drive • Hypoxia and h...

Multifocal atrial When your This happens because the signals that control your heartbeat aren’t working right. In this type of tachycardia, those irregular signals come from three or more places in the heart’s upper chambers. That’s where MAT gets its name. “Multifocal” means having more than one focus and “atrial” refers to the heart’s two upper chambers, called atria. Causes Doctors don’t know exactly what causes MAT. Part of the reason it’s poorly understood is that MAT isn’t a very common type of arrhythmia. MAT usually happens in older people, with an average age of 70. But it sometimes also happens in children or young adults. It’s more common in men and in people with one or more other health problems. These problems may include: • Chronic • Acute respiratory failure • • • • Chronic • • Sometimes MAT happens in people after major surgery. It also can happen in people who have an imbalance of Diagnosis Sometimes people with MAT have these signs: • • Shortness of breath • • A feeling of being lightheaded • Blacking out But many times, people with MAT don’t feel like their heart isn’t beating normally or notice other signs. Doctors often find it unexpectedly in people with other health problems. It’s hard to tell from a Treatment MAT itself isn’t usually life-threatening. But if you have it, it’s likely that you have other serious health conditions -- and those can be very serious. In most cases, the best way to treat MAT is to treat the other health problems. Once tho...

Catherine Ellen Poindexter Professor of Cardiology, Professor of Medicine, Director, Cardiac Arrhythmia Services, Director, Electrophysiology Laboratory, Director, Johns Hopkins ARVD/C Program, Member, Miller-Coulson Academy of Clinical Excellence, Sheikh Zayed Tower - Room 7125 R, 1800 Orleans Street, Baltimore, MD, Hugh Calkins, MD FHRS FACC FAHA FESC, The 2019 ESC Guidelines for the Management of Patients with Supraventricular Tachycardia: What you need to know about the 2019 ESC Guidelines are discussed by Professor Hugh Calkins, Member of the Guideline Writing Group, European Heart Journal, Volume 40, Issue 47, 14 December 2019, Pages 3812–3813, Dr Demos Katritsis and his writing group have produced an important new guidelines document on the management of all types of supraventricular tachycardias (SVTs). The one exception is atrial fibrillation (AF), which is covered in the 2016 European Society of Cardiology (ESC) AF guidelines. This document is a complete rewrite of the 2003 SVT guidelines, which were published as a joint document with the American Heart Association and the American College of Cardiology. In this brief article, I will highlight the most important features of the new 2019 ESC SVT Guidelines. The first important change in the 2019 ESC SVT guideline, when compared with the prior guideline published 16 years earlier is that the Class and level of recommendations supporting catheter ablation for chronic treatment of all types of SVTs have been increase...

Multifocal Atrial Tachycardia (MAT) Overview • A rapid, irregular atrial rhythm arising from multiple ectopic foci within the atria. • Most commonly seen in patients with severe • It is typically a transitional rhythm between frequent premature atrial complexes (PACs) and atrial flutter / fibrillation. AKA “Chaotic atrial tachycardia” Electrocardiographic Features • Heart rate > 100 bpm (usually 100-150 bpm; may be as high as 250 bpm). • Irregularly irregular rhythm with varying PP, PR and RR intervals. • At least 3 distinct P-wave morphologies in the same lead. • Isoelectric baseline between P-waves (i.e. no flutter waves). • Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent PACs). • Some P waves may be nonconducted; others may be aberrantly conducted to the ventricles. There may be additional Clinical Relevance • Usually occurs in seriously ill elderly patients with respiratory failure (e.g. exacerbation of COPD / CHF). • Tends to resolve following treatment of the underlying disorder. • The development of MAT during an acute illness is a poor prognostic sign, associated with a 60% in-hospital mortality and mean survival of just over a year. Death occurs due to the underlying illness; not the arrhythmia itself. Mechanism Arises due to a combination of factors that are present in hospitalised patients with acute-on-chronic respiratory failure: • Right atrial dilatation (from cor pulmonale) • Increased sympathetic drive • Hypoxia and h...

Atrial tachycardia (AT) is a type of abnormal heart rhythm, or What happens during atrial tachycardia? A normal heartbeat begins with an electrical impulse from the sinus node, a single point in the heart's right atrium (right upper chamber). During atrial tachycardia, an electrical impulse outside the sinus node fires repeatedly, often due to a short circuit — a circular electrical pathway. Electricity circles the atria again and again, causing the upper chambers to contract more than 100 times per minute. (A An arrhythmia centered in the upper chambers of the heart is called a supraventricular tachycardia (SVT) — literally, fast "heartbeat above the ventricles" (lower chambers). Atrial tachycardia usually occurs for brief periods and starts and stops spontaneously. That's called paroxysmal AT. If it continues, it is called persistent AT What are the symptoms of atrial tachycardia? Atrial tachycardia may cause no symptoms at all or may cause any of the following: • Palpitations (a fluttering in the chest) • Fainting • Chest pain • Shortness of breath • Fatigue • Heart failure What causes atrial tachycardia? Atrial tachycardia occurs most commonly in elderly patients and those with other types of heart disease, though it occasionally appears in children, younger people and those with healthy hearts. Causes include: • A "stretched" atrium resulting from high blood pressure ( • A previous heart attack • Excessive use of alcohol, cocaine and other stimulants • An "irritable f...

Multifocal atrial When your This happens because the signals that control your heartbeat aren’t working right. In this type of tachycardia, those irregular signals come from three or more places in the heart’s upper chambers. That’s where MAT gets its name. “Multifocal” means having more than one focus and “atrial” refers to the heart’s two upper chambers, called atria. Causes Doctors don’t know exactly what causes MAT. Part of the reason it’s poorly understood is that MAT isn’t a very common type of arrhythmia. MAT usually happens in older people, with an average age of 70. But it sometimes also happens in children or young adults. It’s more common in men and in people with one or more other health problems. These problems may include: • Chronic • Acute respiratory failure • • • • Chronic • • Sometimes MAT happens in people after major surgery. It also can happen in people who have an imbalance of Diagnosis Sometimes people with MAT have these signs: • • Shortness of breath • • A feeling of being lightheaded • Blacking out But many times, people with MAT don’t feel like their heart isn’t beating normally or notice other signs. Doctors often find it unexpectedly in people with other health problems. It’s hard to tell from a Treatment MAT itself isn’t usually life-threatening. But if you have it, it’s likely that you have other serious health conditions -- and those can be very serious. In most cases, the best way to treat MAT is to treat the other health problems. Once tho...

Atrial tachycardia (AT) is a type of abnormal heart rhythm, or What happens during atrial tachycardia? A normal heartbeat begins with an electrical impulse from the sinus node, a single point in the heart's right atrium (right upper chamber). During atrial tachycardia, an electrical impulse outside the sinus node fires repeatedly, often due to a short circuit — a circular electrical pathway. Electricity circles the atria again and again, causing the upper chambers to contract more than 100 times per minute. (A An arrhythmia centered in the upper chambers of the heart is called a supraventricular tachycardia (SVT) — literally, fast "heartbeat above the ventricles" (lower chambers). Atrial tachycardia usually occurs for brief periods and starts and stops spontaneously. That's called paroxysmal AT. If it continues, it is called persistent AT What are the symptoms of atrial tachycardia? Atrial tachycardia may cause no symptoms at all or may cause any of the following: • Palpitations (a fluttering in the chest) • Fainting • Chest pain • Shortness of breath • Fatigue • Heart failure What causes atrial tachycardia? Atrial tachycardia occurs most commonly in elderly patients and those with other types of heart disease, though it occasionally appears in children, younger people and those with healthy hearts. Causes include: • A "stretched" atrium resulting from high blood pressure ( • A previous heart attack • Excessive use of alcohol, cocaine and other stimulants • An "irritable f...