ECG 6: What is Wandering Atrial Pacemaker?

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What are its causes and treatment?

Wandering atrial pacemaker

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Wandering atrial pacemaker produces a supraventricular rhythm in which a pacemaker impulses originate from two or more sites in the SA node, atria, or AV junction and discharge at a rate of 60 to 100 bpm.


  1. Chronic lung disease
  2. Valvular heart disease


  1. P wave morphologies vary because impulses originate from different sites.
  2. P-P intervals may also vary because each impulse travels through the atria via a slightly different route.
  3. There is one P wave fore every QRS complex.
  4. The overall atrial and ventricular rates remain between 60-100 bpm.
  5. QRS complexes are usually unchanged. They are narrow as long as ventricular depolarization is undisturbed.

Treatment of the underlying cause

answered May 23, 2013 by Mike Junior Resident (2,007 points)