Wandering Pacemaker

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When several pacemakers are competing, p-waves with different origins and thus configurations occur. The rhythm is slightly different from beat to beat.

Wandering pacemaker. Every p-wave is different and thus has a different origin.

note If the heart rate increases to above 100bpm, it is called Multifocal Atrial Tachycardia. Possible causes are hypoxia, COPD and medication such as digoxin.