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For further information, see CMDT Part 12-10: Atrial Tachycardia
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Essentials of Diagnosis
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Characterized by bursts of rapid, regular tachycardia
Multifocal atrial tachycardia commonly seen with severe chronic obstructive pulmonary disease (COPD) and presents with ≥ 3 distinct P wave morphologies on ECG, often confused for atrial fibrillation
Treatment of the underlying lung disease is most effective therapy
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General Considerations
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Usually intermittent and self-limiting
Incessant forms do exist and may present with signs and symptoms of heart failure due to tachycardia-induced cardiomyopathy
Palpitations with an abrupt onset, similar to other forms of paroxysmal supraventricular tachycardia (PSVT)
Dyspnea or angina can present in patients with underlying cardiac pathology (eg, coronary heart disease)
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12-lead ECG
Close inspection of the P wave suggests a focus away from the sinus node, although certain locations (eg, high right atrial crista terminalis) may mimic sinus tachycardia
In this situation, the abrupt onset and offset of the arrhythmia is helpful in distinguishing atrial from sinus tachycardia, although electrophysiologic study is sometimes necessary
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