Multifocal Atrial Tachycardia: A Classic Electrocardiogram

The EKG presented here shows irregular ventricular rate greater than 100 beats per minute. The P-P intervals are irregular with more than 3 different morphologic P waves in the same EKG leads. There is an isoelectric baseline between the P waves and well-organized atrial activity. The P-R and R-R intervals are irregular as well. This EKG finding was noted in an elderly patient with decompensated chronic lung disease who was known to have end-stage chronic obstructive pulmonary disease and presented with community-acquired pneumonia. 

Note: Verbal informed consent was obtained from the patient to publish the anonymized information in this article.