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Wandering Atrial Pacemaker - Atrial Dysrhythmias.

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  • Rhythms are often named according to the origin of the electrical activity in the heart or the structure where the problem is occurring.
  • Wandering Atrial Pacemaker is aptly named due to the electrical impulses causing the atrial activity are moving or wandering.
  • These changes in the locus of stimulation affect the morphology of the P waves.


wandering atrial pacemaker tracing
  • In Wandering Atrial Pacemaker, you must observe at least three different shaped P waves. No other changes in the tracing may be observed. The rhythm may or may not be regular.
  • The PR interval is often affected, but does not have to be.
  • The bottom line, is you must observe at least three different shaped P waves.

Practice Strip

wandering atrial pacemaker tracing

Analyze this tracing using the five steps of rhythm analysis.

Show Answer
  • Rhythm: Irregular
  • Rate: 50
  • P wave: Changing Shapes (3 or more)
  • PR interval: Variable
  • QRS: 0.08
  • Interpretation: Wandering Atrial Pacemaker

Authors and Reviewers

Authored by Thomas O'Brien
Medically reviewed by Dr. Jonathan Keroes, MD, Cardiology
Last Update: 11/8/2020

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