Multifocal atrial tachycardia

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  1. Characterized by multiple p wave morphologies and a variable PR interval, ventricular rate is irregular
  2. Most often seen in patients with chronic lung disease or theophylline therapy, hypokalemia, magnesium deficiency, acute pulmonary embolism, acute MI and congestive heart failure
    1. the risk of postoperative congestive heart failure persists for at least 2 days after surgery
    2. the risk for postoperative MI persists for at least 5-6 days after surgery; most postoperative MIs are non Q wave type
    3. persons with decreased ejection fractions due to previously unrecognized MIs have a significantly increased risk of cardiac death
  3. Treatment: treat underlying cause (K, Mg, stop theophylline), metoprolol
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