.Multi-focal atrial tachycardia is typified by atrial rates of 100 to 130 beats/minute and variation in the P wave morphology on the electrocardiogram. Multi-focal atrial tachycardia is more commonly seen in the elderly due to digoxin toxicity or chronic pulmonary disease.32,33 Treatment of the underlying cause with the addition of either a beta-blocker in the absence of airways disease, verapamil or amiodarone is appropriate.