Diagnostic criteria


  The impulses originate not only from the sinus rhythm but also from different ectopic atrial foci.

      Therefore, there are P waves with
at least 3 different configurations.

  The impulses originate not only from the sinus rhythm but also from different ectopic atrial foci.

      Therefore PP, PR and RR
intervals vary.

  Each P wave is followed by a QRS complex.

  The QRS complexes are narrow (<120msec) since the impulse originates from the atria.

  The heart rate is between
60-100/minute and irregular.

  Generally seen under
increased vagal tone.





ECG 1. Wandering atrial pacemaker is seen on the Holter tracing above. The
P waves have at least 3 different configurations

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ECG 2. Wandering atrial pacemaker in a patient with chronic obstructive lung disease.
P waves have different shapes.

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ECG 3. Wandering atrial pacemaker. There are
P waves with at least 3 different configurations .

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ECG 4. Wandering atrial pacemaker in another patient.

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ECG 5. The ECG above belongs to a 65 years-old hypertensive woman.
P waves with at least 3 different shapes suggest
"
wandering atrial pacemaker . In addition, there is also left ventricular hypertrophy pattern according to the Cornell voltage
and Gubner criteria.

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ECG 6. Wandering atrial pacemaker (P waves with at least 3 different shapes). The above ECG belongs to an 11 years-old boy.

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