Seema A Kothari1, Sirin Apiyasawat, Navaid Asad, David H Spodick. 1. Department of Medicine, Worcester Medical Center, and Division of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester, MA 01655, USA.
Abstract
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. HYPOTHESIS: 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. METHODS AND 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). CONCLUSION: The rate threshold of MAT should be reduced from 100 to 90 beats/min.
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. HYPOTHESIS: 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. METHODS AND 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). CONCLUSION: The rate threshold of MAT should be reduced from 100 to 90 beats/min.