Evidence supporting a new rate threshold for multifocal atrial tachycardia.
BACKGROUND
Exacerbation of chronic obstructive pulmonary disease (COPD) is overwhelmingly represented among patients presenting with multifocal atrial tachycardia (MAT) and has been used as a paradigm for such patients. The quasidiagnostic tachycardia threshold for MAT is conventionally set at 100 beats/min. Nevertheless, this threshold has not been demonstrated to be optimal.


OBJECTIVE
Using COPD as a paradigm for MAT, clinical experience led to the hypothesis that MAT with a tachycardia threshold < 100 beats/min could be more closely associated with COPD exacerbation.


RESULTS
We reviewed 60 consecutive patients with multifocal atrial arrhythmia (MAA) at any heart rate and found a better association between the incidence of COPD exacerbations and MAT using a tachycardia threshold of 90 beats/min (p = 0.00036) than when using a threshold of 100 beats/min (p = 0.515).


CONCLUSIONS
The rate threshold of MAT should be reduced from 100 to 90 beats/min.
Kothari
Seema A
SA
Department of Medicine, Worcester Medical Center, and Division of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester, MA 01655, USA.
Apiyasawat
Sirin
S
Asad
Navaid
N
Spodick
David H
DH
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013612:Tachycardia, Ectopic Atrial / Q000150:complications / Q000175:diagnosis*