Multifocal atrial tachycardia

Multifocal atrial tachycardia is a cardiac arrhythmia, specifically a type of supraventricular tachycardia. It is characterized by an electrocardiogram (ECG) strip with P-waves of variable morphology and varying P-R intervals, plus tachycardia, which is a heart rate exceeding 100 beats per minute.

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The P-waves and P-R intervals are variable due to a phenomenon called wandering atrial pacemaker (WAP). The electrical impulse is generated at a different focus within the atria of the heart each time. WAP is positive once the heart generates at least three different P-wave formations from the same ECG lead. Then, if the heart rate exceeds 100 beats per minute, the phenomenon is called multifocal atrial tachycardia.

It is sometimes associated with digitalis toxicity in patients with heart disease.