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Treatment of Multifocal Atrial Tachycardia by Treatment of Pulmonary Insufficiency : Or Is it Vice Versa?

Toby R. Engel, MD; Selvaratnam Radhagopalan, MD
Author and Funding Information

Affiliations: Camden, NJ 
 ,  Drs. Engel and Radhagopalan are from the Cooper Hospital/University of Medical Center and the Robert Wood Johnson Medical School at Camden.

Correspondence to: Toby R. Engel, MD, Cardiology Division, Cooper University Hospital, Robert Wood Johnson Medical School at Camden, One Cooper Plaza, Camden, NJ 08103; e-mail: Engel-toby@cooperhealth.EDU



Chest. 2000;117(1):7-8. doi:10.1378/chest.117.1.7
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Extract

“He is the best physician who knows the worthlessness of the most medicines.”

Benjamin Franklin, Poor Richard’s Almanac

In this issue of CHEST, Ueng et al (see page 52) use radiofrequency energy to modify or control the ventricular response to multifocal atrial tachycardia (MAT) in the setting of COPD, for the most part avoiding drugs that might exacerbate lung or heart failure. Their 13 patients did not receive mechanical ventilation, they were not given very high doses of theophyline, and they did not have uncorrected blood gas disturbances. Ventricular rate was immediately reduced from an average of 145 beats/min to 89 beats/min (one patient later required a pacemaker; one required a second procedure). Symptoms and quality of life improved at 6-month follow-up, as did left ventricular ejection fraction. Serum theophyline levels, FEV1, and FVC were unchanged, and do not explain the better quality of life or that most patients did not have recurrence of MAT, even transiently when searched for on a Holter monitor.


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