A wandering pacemaker rhythm is a supraventricular rhythm with varying locations of impulse formation resulting in three or more different P waves. With a narrow QRS complex, the absence of a P wave qualifies as one type of P wave. In the rhythm above, note the P waves from the sinus node, the atria and the junction.
Can be diagnosed by the variation of the length; it is not symmetrical, rather it is variant.
It does not need treatment, as it is a benign condition, but it is recommended to monitor the clinical status.
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