Wandering Atrial Pacemaker

Rate	Variable depending on the site of the pacemaker; usually 60-100/ bpm.
P wave	Variable P morphology, P-P interval and P-R interval
QRS	Normal
Conduction	P-R interval varies depending on the locus of the pacemaker
Rhythm	Irregular

Wandering atrial pacemaker (WAP) is a benign atrial arrhythmia often incidentally diagnosed during examination of elderly patients suffering from obstructive pulmonary diseases. WAP has also been documented as an occupational occurence in weight lifters who undergo repetitive valsava maneuvers and respiratory straining. French horn players, too, have documented cases while playing. In children, wandering atrial pacemaker may result during their normal developmental changes in anatomy and physiology.

The condition is usually self limiting. There is no specific treatment but the condition should be monitored and underlying causes like sick sinus or lung disease should be treated.

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