A wandering pacemaker is an irregular heartbeat caused by a shift in the position of the heart’s natural pacemaker, usually not a cause for concern and requires no further treatment. It can be diagnosed with an ECG and may be associated with other health issues.
A wandering pacemaker is a type of arrhythmia characterized by a shift in the position of the heart’s natural pacemaker. The result is an irregular heartbeat, with a P wave — the wave that indicates a shift in electrical activity from the right atrium to the left atrium — that shifts when the heartbeat is viewed on an electrocardiograph (ECG). This arrhythmia is usually not a cause for concern and requires no further treatment. However, there may be cases where it is associated with another health issue that needs attention.
The heart’s natural pacemaker is located in the sinoatrial (SA) node, an area in the upper right atrium. This area includes a group of pacemaker cells that determine the rhythm of the heart. In someone with a wandering pacemaker, sometimes cells in the atrioventricular (AV) node, in the lower area of the right atrium, temporarily take over the pacemaker duties. This results in irregularities in the heartbeat which the patient can usually feel and which will also show up as irregularities on an ECG.
The vagus nerve is a nerve that regulates the heartbeat; è “tone” is the level of activity or impulses sent by the nerve. A decrease in vagal tone can cause the AV node to begin regulating the heartbeat. When the tone increases, the SA node will resume its role. This type of malfunction can occur in response to stress and other pressures and can occur independently or in connection with certain medications or conditions.
A doctor can diagnose an errant pacemaker with the assistance of an ECG to visualize the heartbeat. By examining patterns on the ECG, the doctor can determine not only that the patient has an arrhythmia, but what type of arrhythmia the patient has and what could be causing it. Wandering pacemakers are a form of atrial arrhythmia because they originate in the right atrium of the heart.
Patients who have a wandering pacemaker may want to make sure it is noted on their charts so that when interacting with new care providers, their care providers aren’t concerned or scared about the arrhythmia. It may also be necessary for some patients to present to cardiologists for the purpose of monitoring heart function to confirm that the heart is still healthy and to determine whether or not more aggressive treatment options should be pursued.
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