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Medicine ECG and Arrhythmia 2 cd3038ff

A 70 year old COPD patients presents with palpitations. ECG rhythm strip shows?

A
Inappropriate sinus Tachycardia
B
Junctional Tachycardia
C
Atrial fibrillation
D
Multifocal Atrial Tachycardia
High-Yield Explanation
ECG strip shows a hea rate of approximately 120/min with normal sinus rhythm. However a very peculiar finding is present here with variable P wave morphology. MC arrhythmia in COPD patients is M.A.T (Multifocal atrial tachycardia). It originates due to multiple ectopic foci in atria. Choice A has an exaggerated response to emotional stimuli like fear. Choice B has Retrograde P waves with narrow complex QRS. (Blue arrows) Choice C has absent P waves with irregular RR interval.

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