A 64-year-old man presents with increased shortness of breath. He has a past history of chronic obstructive pulmonary disease (COPD) and recently developed increased cough and sputum production but no fever or chills. He appears in mild respiratory distress, respirations are 26/min, pulse 120 beats/min, blood pressure 145/84 mm Hg, and oxygen saturation 90%. He has bilateral expiratory wheezes. His ECG reveals multifocal atrial tachycardia (MAT) (discrete P waves with at least three different morphologies).For the above patient with an arrhythmia, select the most appropriate treatment.
MAT usually occurs in the setting of advanced lung disease. Treatment involves withdrawing theophylline and improving lung function. There may be some role for treatment with verapamil.
digitalis
verapamil
diltiazem
beta-blockers
C.V.S.