What Is a Wandering Atrial Pacemaker?

Heart arrhythmias

A wandering atrial pacemaker is a type of heart arrhythmia. An arrhythmia is a problem with the rhythm or rate of your heartbeat. Types of arrhythmias include extra beats, fast or slow heart rate, or an irregularity that occurs in the lower chambers of your heart.
Some arrhythmias are serious medical conditions.
Others are common and nothing to be worried about. In most cases, a wandering atrial pacemaker is no cause for concern. To be safe, you should see your doctor if you’re experiencing an unusual heartbeat.

The movement of blood

Your heart has two upper chambers, your right and left atria. It also has two lower chambers, your right and left ventricles. Your blood follows a specific path through them to move blood properly through your body.
First, oxygen-depleted blood from your body moves into your right atrium. From there, it moves into your right ventricle. Then it’s pumped into your lungs. After it picks up oxygen from your lungs, it moves into your left atrium. Then it moves into your left ventricle. From there, the oxygen-rich blood is pumped to the rest of your body

The role of electrical impulses

To move blood between the chambers of your heart, your heart muscle needs to contract. In other words, your atria and ventricles squeeze to move blood through your heart and body.
These contractions are controlled by electrical impulses that come from specialized cells. These cells are able to conduct electricity and transmit impulses along to more cells. They cause your heart chambers to contract, following a certain rate and rhythm that keeps your blood moving

Your SA node

A set of cells on the top of your right atrium, called your sinoatrial (SA) node, controls the rate and rhythm of your heart’s electrical impulses. For this reason, it’s often called your natural pacemaker. It’s responsible for initiating your heart contractions, and therefore beating, at the appropriate rate and rhythm.

Your AV node

Your SA node, or natural pacemaker, doesn’t work alone. It has important partners that help conduct electrical impulses through your heart.
From your SA node, electrical impulses move to your atrioventricular (AV) node. This set of cells is located a little further down in your heart. It conveys the electrical impulses on to fibers that carry the signals through your heart. This maintains your heart’s synchronized contractions

A wandering atrial pacemaker

A wandering atrial pacemaker is an arrhythmia that occurs when the control of your heart’s electrical impulses wanders from your SA node to your AV node.
A wandering atrial pacemaker can occur in different situations, such as when you’re working out or sleeping. It’s almost never a cause for concern. In some cases, it produces an irregularity in your heartbeat. In other cases, it doesn’t. You may not even notice when it’s happening

Risk factors

Anyone can get a wandering atrial pacemaker, but it’s more common in older adults and young children. It’s also common in athletes and other people who are in excellent physical condition. The reasons for this are unknown.
In most cases, doctors don’t know what causes a wandering atrial pacemaker. In rare cases, it can be caused by digoxin toxicity. This is a complication of digitalis therapy, which is used to treat some heart conditions.

Diagnosis

An electrocardiogram (ECG) is a diagnostic tool that your doctor can use to measure the electrical activity in your heart. An ECG reading looks like a series of waves. There’s a peak that represents the contraction of your right atrium, caused by your SA node. It’s known as the P wave.
Your doctor can tell that you have a wandering atrial pacemaker if you have an irregularity in the P wave on your ECG. The shape, size, and position of your P wave may look different.

• Treatment

  

  In most cases, a wandering atrial pacemaker doesn’t require treatment. But you will need treatment if the condition is caused by digoxin toxicity. This is a potential side effect of digitalis therapy. Digitalis is a medicine used to treat some heart conditions. Your doctor may advise you to stop taking digitalis or adjust your dose.
  

  Multifocal atrial tachycardia

  

  If you suspect you have a wandering atrial pacemaker or other arrhythmia, make an appointment with your doctor. You may actually have multifocal atrial tachycardia. This is another type of arrhythmia that’s similar to a wandering atrial pacemaker, but more serious.
  If you have multifocal atrial tachycardia, the nodes in your heart fire off electrical impulses at the same time. This often causes a rapid heart rate, which distinguishes it from a wandering atrial pacemaker. This type of arrhythmia can cause serious problems and needs treatment.