Multifocal atrial tachycardia is a rhythm with at least three different P wave morphologies that is often associated with lung disease. Treatment involves managing the underlying illness, and not direct rate control.
Multifocal Atrial Tachycardia

Examples

Multifocal Atrial Tachycardia
Multifocal atrial tachycardia in a patient with chronic obstructive lung disease. There is also low voltage due to increased impedance from hyperinflated lungs.
Multifocal Atrial Tachycardia
Multifocal atrial tachycardia in a patient with heart failure and chronic obstructive pulmonary disease.References
- Wagner GS, Strauss DG. Marriott’s Practical Electrocardiography. 12th ed. Lippincott Williams & Wilkins; 2014