Wandering atrial pacemaker
Wandering atrial pacemaker is an atrial arrhythmia that occurs when the natural cardiac pacemaker site shifts between the sinoatrial node, the atria, and/or the atrioventricular node. This shifting of the pacemaker from the SA node to adjacent tissues is identifiable on ECG Lead II by morphological changes in the P-wave; sinus beats have smooth upright P waves, while atrial beats have flattened, notched, or diphasic P-waves.
It is often seen in the very young, very old, and in athletes, and rarely causes symptoms or requires treatment.Cause
