Wandering atrial pacemaker: Difference between revisions
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==Overview== | ==Overview== | ||
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This atrial arrhythmia occurs when the natural cardiac pacemaker site shifts between the SA node, the atria, and/or the AV node. This shifting of the pacemaker from the SA node to adjacent tissues is manifested electrocardiographically by transient changes in the size shape and direction of the P waves. | This atrial arrhythmia occurs when the natural cardiac pacemaker site shifts between the SA node, the atria, and/or the AV node. This shifting of the pacemaker from the SA node to adjacent tissues is manifested electrocardiographically by transient changes in the size shape and direction of the P waves. | ||
A wandering pacemaker is usually caused by varying vagal tone. With increased vagal tone the SA Node slows,allowing a pacemaker in the atria or AV Nodal area,which may become slightly faster briefly. After vagal tone decreases the SA Node becomes the pacemaker again. | A wandering pacemaker is usually caused by varying vagal tone. With increased vagal tone the SA Node slows,allowing a pacemaker in the atria or AV Nodal area,which may become slightly faster briefly. After vagal tone decreases the SA Node becomes the pacemaker again. | ||
Note that if the heart rate increases to above 100bpm, it is called [[Multifocal Atrial Tachycardia]]. Possible causes are [[hypoxia]], [[COPD]] and medication such as [[digoxin]]. | |||
==EKG | ==Wandering Atrial Pacemaker EKG Examples== | ||
Shown below is an EKG image of wandering atrial pacemaker. When several pacemakers are competing, p-waves with different origins and thus configurations occur. The rhythm is slightly different from beat to beat. | |||
[[File:Wandering_Atrial_Pacemaker_1.png|500px|center]] | |||
==Sources== | |||
*Copyleft images obtained courtesy of ECGpedia, http://en.ecgpedia.org/index.php?title=Special:NewFiles&offset=&limit=500 | |||
== | ==External Links== | ||
* [http://0-www.nhlbi.nih.gov.innopac.up.ac.za:80/health/dci/Diseases/ekg/ekg_what.html National Heart, Lung, and Blood Institute, Diseases and Conditions Index] | * [http://0-www.nhlbi.nih.gov.innopac.up.ac.za:80/health/dci/Diseases/ekg/ekg_what.html National Heart, Lung, and Blood Institute, Diseases and Conditions Index] | ||
* [http://www.health.gov.mt/impaedcard/issue/issue1/ipc00103.htm EKG Interpretations in infants and children] | * [http://www.health.gov.mt/impaedcard/issue/issue1/ipc00103.htm EKG Interpretations in infants and children] | ||
==References== | |||
{{Reflist|2}} | |||
{{Electrocardiography}} | {{Electrocardiography}} |
Revision as of 14:25, 16 October 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
This atrial arrhythmia occurs when the natural cardiac pacemaker site shifts between the SA node, the atria, and/or the AV node. This shifting of the pacemaker from the SA node to adjacent tissues is manifested electrocardiographically by transient changes in the size shape and direction of the P waves. A wandering pacemaker is usually caused by varying vagal tone. With increased vagal tone the SA Node slows,allowing a pacemaker in the atria or AV Nodal area,which may become slightly faster briefly. After vagal tone decreases the SA Node becomes the pacemaker again. Note that if the heart rate increases to above 100bpm, it is called Multifocal Atrial Tachycardia. Possible causes are hypoxia, COPD and medication such as digoxin.
Wandering Atrial Pacemaker EKG Examples
Shown below is an EKG image of wandering atrial pacemaker. When several pacemakers are competing, p-waves with different origins and thus configurations occur. The rhythm is slightly different from beat to beat.
Sources
- Copyleft images obtained courtesy of ECGpedia, http://en.ecgpedia.org/index.php?title=Special:NewFiles&offset=&limit=500
External Links
- National Heart, Lung, and Blood Institute, Diseases and Conditions Index
- EKG Interpretations in infants and children