A 68-year-old male admitted to ICU for acute exacerbation of COPD develops a sudden onset of palpations. The following ECG changes are seen. What is the most likely diagnosis?

Ans. (D) MAT(Ref. Harrison's Principle of Internal Medicine 20th Ed; Page No-1733 and 1745)ECG shows narrow complex tachycardia with irregular rhythm.Since P waves are seen it rules out AEDifferent morphologies of P waves (>=3) in lead II rules out Sinus arrhythmia.All the above said features confirm MAT.Also absence of chest pain & significant ST elevations rules out AMI.Multifocal Atrial Tachycardia (MAT)ECG FindingsHeart rate typically between 100-150 bpm.Irregularly irregular rhythm with varying PP, PR and RR intervals.At least 3 distinct P-wave morphologies in the same lead.Isoelectric baseline between P-waves (i.e. no flutter waves).