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.