Normal ejection fraction was restored in 97% of patients after successful ablation.188 IIa C-LD 1. Oral beta blockers, diltiazem, or verapamil are reasonable for ongoing management in patients with symptomatic focal AT.123,204,205 See Online Data Supplement 6. Data on long-term drug therapy of focal AT are limited to observational studies, and some studies did not provide clear inclusion criteria, so results for AT were combined with those for other mechanisms of SVT. Nevertheless, these drugs are moderately effective, with a low incidence of significant adverse effects.123,204,205,209 214 IIa C-LD Flecainide or propafenone can be effective for ongoing management in patients without structural heart disease or ischemic heart disease who have focal AT.209 213 See Online Data Supplement 6. Small case series studies reported that focal AT suppression was achieved with flecainide in most patients.209,210 In infants and children, propafenone is moderately effective in focal AT suppression during follow-up.213 Flecainide and propafenone are generally tolerated by patients with focal AT. Combinations of a class Ic drug with a beta blocker, diltiazem, or verapamil may improve overall efficacy rates. IIb C-LD 1. Oral sotalol or amiodarone may be reasonable for ongoing management in patients with focal AT.188,211,215 219 See Online Data Supplement 6. Several studies reported moderate efficacies of oral sotalol or amiodarone in maintaining sinus rhythm in long-term treatment in Although most reports are in children, limited data suggest similar efficacy in adults.218 Because of the risk of proarrhythmia and other complications, before use of these drugs, a balance between anticipated benefit of focal AT suppression and potential adverse effects of these drugs should be carefully considered. 4.2. Multifocal Atrial Tachycardia MAT is defined as a rapid, irregular rhythm with at least 3 dis- tinct morphologies of P waves on the surface ECG. 