Wandering Atrial Pacemaker

Rate variable depending on the site of the pacemaker; usually 45-100/ bpm.
P wave also variable in morphology
QRS normal
Conduction P-R interval varies depending on the site of the pacemaker
Rhythm irregular

This dysrhythmia may occur in normal hearts as a result of fluctuations in vagal tone. It may also be seen in patients with heart disease or COPD.

Wandering atrial pacemaker may also be a precursor to multifocal atrial tachycardia.

There is usually no treatment required.

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