View source for Wandering atrial pacemaker

==Background==
*Three or more ectopic foci within the atrial myocardium serve as the pacemaker
*Rate is less than 100bpm (in contrast to [[MAT]])
*Is irregularly irregular therefore sometimes confused with [[atrial fibrillation]] and sinus arrhythmia

===Causes===
* Intrinsic cardiac or pulmonary disease
* Metabolic derangements
* Drug toxicity (including [[Digoxin toxicity|Digoxin]])

==Clinical Features==
* Often seen in the extremes of age and in athletes
* Rarely causes symptoms

==Differential Diagnosis==
{{Palpitations DDX}}

==Evaluation==
[[File:Wandering atrial pacemaker.JPG|thumb|]]
[[File:Wandering atrial pacemaker.png|thumb|]]
===Workup===
*[[ECG]]

===Diagnosis===
*ECG should show three distinct P wave morphologies with a ventricular rate <100bpm

==Management==
*Rarely requires treatment

==Disposition==
*Outpatient management

==See Also==
*[[Multifocal atrial tachycardia]]
*[[Dysrhythmia]]
*[[ECG (main)]]

==External Links==

==References==
<references/>

[[Category:Cardiology]]