Multifocal Atrial Tachycardia कारण, लक्षण और इलाज

Multifocal Atrial Tachycardia (MAT / मल्टीफोकल एट्रियल टैकीकार्डिया) एक rare cardiac arrhythmia है जिसमें atria (अटरिया / हृदय के उपरी कक्ष) से multiple impulses generate होते हैं।

• इस condition में heart rate usually 100–200 beats per minute होता है।
• Commonly यह elderly patients और severe pulmonary disease वाले patients में देखा जाता है।
• Electrocardiogram (ECG) पर three or more distinct P-wave morphologies दिखाई देती हैं।

Multifocal Atrial Tachycardia क्या है  (What is MAT)

• MAT में atria से multiple pacemaker sites firing करती हैं

• ECG features:

  1. Heart rate >100 bpm
  1. At least three different P-wave morphologies
  1. Irregularly irregular rhythm
  1. Variable PR interval

• यह condition hemodynamically usually stable होती है, लेकिन underlying disease गंभीर हो सकती है।

Multifocal Atrial Tachycardia कारण (Causes of Multifocal Atrial Tachycardia)

1. Pulmonary Disease (सबसे common cause)

• Chronic obstructive pulmonary disease (COPD)
• Pulmonary embolism
• Hypoxia (ऑक्सीजन की कमी)

2. Electrolyte Imbalance

• Hypokalemia (potassium कमी)
• Hypomagnesemia (magnesium कमी)

3. Cardiac Disease

• Heart failure
• Coronary artery disease

4. Medications / Drugs

• Theophylline overdose (COPD patients)
• Adrenergic agonists (salbutamol, epinephrine)

5. Others

• Sepsis, pneumonia
• Advanced age

MAT usually secondary to underlying illness rather than primary cardiac disease।

Multifocal Atrial Tachycardia लक्षण (Symptoms of Multifocal Atrial Tachycardia)

• Palpitations (heartbeat fast or irregular)
• Shortness of breath (dyspnea)
• Fatigue
• Lightheadedness or dizziness
• Chest discomfort (rare)

कभी-कभी MAT asymptomatic भी हो सकती है और सिर्फ ECG पर पता चलता है।

Multifocal Atrial Tachycardia कैसे पहचाने (Diagnosis of Multifocal Atrial Tachycardia)

1. Electrocardiogram (ECG) – primary diagnostic tool
   1. Three or more P-wave morphologies
   1. Irregularly irregular rhythm
   1. Variable PR interval
2. Blood Tests
   1. Electrolytes (K+, Mg2+)
   1. Arterial blood gases for hypoxia
3. Chest X-ray / CT scan – underlying pulmonary disease
4. Echocardiography – evaluate cardiac function

ECG finding of ≥3 different P waves in one lead is hallmark of MAT।

Multifocal Atrial Tachycardia इलाज (Treatment of Multifocal Atrial Tachycardia)

1. Treat Underlying Cause

• Correct hypoxia – oxygen therapy
• Treat COPD exacerbation, pneumonia, or pulmonary embolism
• Correct electrolyte imbalance (potassium, magnesium)

2. Medications (if symptomatic)

• Beta-blockers (e.g., metoprolol) – only if hemodynamically stable
• Calcium channel blockers (verapamil) – sometimes preferred
• Avoid digoxin (usually ineffective)

3. Supportive Measures

• Monitor heart rate and rhythm
• Maintain adequate hydration
• Treat infection or sepsis promptly

Goal: normalize heart rate and treat underlying condition, not just suppress arrhythmia।

रोकथाम (Prevention)

• Manage chronic pulmonary disease effectively
• Avoid drugs that may precipitate MAT
• Maintain electrolyte balance
• Regular cardiac and pulmonary check-ups for high-risk patients

सावधानियाँ (Precautions)

• Monitor for hemodynamic instability (hypotension, severe tachycardia)
• Avoid self-medication with stimulants
• Hospitalization required if symptomatic or severe underlying illness
• Continuous ECG monitoring in ICU settings for severe patients

FAQs (अक्सर पूछे जाने वाले प्रश्न)

Q1. क्या MAT life-threatening है?

Usually benign if underlying cause treated, but severe pulmonary disease या electrolyte imbalance में complications हो सकते हैं।

Q2. MAT को कितनी जल्दी ठीक किया जा सकता है?

Depends on underlying cause; correction of hypoxia/electrolytes usually resolves MAT within hours to days।

Q3. क्या medications हमेशा जरूरी हैं?

नहीं, अक्सर underlying illness treatment से arrhythmia self-resolves।

Q4. MAT और atrial fibrillation में क्या अंतर है?

MAT में ≥3 P-wave morphologies, irregularly irregular rhythm, और variable PR interval; atrial fibrillation में no distinct P waves और totally irregular ventricular response।

निष्कर्ष (Conclusion)

Multifocal Atrial Tachycardia (मल्टीफोकल एट्रियल टैकीकार्डिया) अक्सर secondary arrhythmia होती है, mostly elderly patients और severe pulmonary disease में।
Early recognition, ECG diagnosis, underlying cause treatment, electrolyte correction, और supportive therapy से यह reversible है।
यदि palpitations, breathlessness या fatigue दिखाई दें, तो तुरंत cardiologist से consultation करें।