Wandering Atrial Pacemaker / Multifocal Atrial Tachycardia

Lead II

Wandering Atrial Pacemaker:

Multi Focal Tachycardia:

 

12-Lead

 

Interpretation Rules

  • Heart rate <100bpm for Wandering Atrial Pacemaker.
  • Heart rate > 100 bpm (usually 100-150 bpm; may be as high as 250 bpm) for MAT.
  • Irregularly irregular rhythm with varying PP, PR and RR intervals.
  • At least 3 distinct P-wave morphologies in the same lead.
  • Isoelectric baseline between P-waves (i.e. no flutter waves).
  • Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent PACs).
  • Some P waves may be nonconducted; others may be aberrantly conducted to the ventricles.
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