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Atrial tachycardia is a type of heart rhythm problem in which the heart's electrical impulse comes from an ectopic pacemaker (that is, an abnormally located cardiac pacemaker) in the upper chambers of the heart, rather than from the sinoatrial node, the normal origin of the heart's electrical activity.
The presentation and symptoms a patient can present with are varied and often dependent on the underlying cause of the junctional rhythm. Patient's can be asymptomatic for example, or experience difficulty breathing and chest pain if they have underlying congestive heart failure.
Atrial tachycardia with complete A-V block and resulting junctional escape Many conditions can cause third-degree heart block, but the most common cause is coronary ischemia . Progressive degeneration of the electrical conduction system of the heart can lead to third-degree heart block.
Another heart rhythm similar to wandering atrial pacemaker is multifocal atrial tachycardia. Both arrhythmias have at least 3 different P-wave morphologies in a single ECG lead, but the heart rate is different. When the heart rate is lower than 100 beats per minute, the heart rhythm is considered wandering atrial pacemaker.
Multifocal atrial tachycardia is characterized by an electrocardiogram (ECG) strip with three or more discrete P wave morphologies in the same lead, not including that originating from the sinoatrial node, plus tachycardia, which is a heart rate exceeding 100 beats per minute (although some suggest using a threshold of 90 beats per minute ...
A right bundle branch block typically causes prolongation of the last part of the QRS complex and may shift the heart's electrical axis slightly to the right. The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the ...
Premature atrial contractions are often benign, requiring no treatment. Occasionally, the patient having the PAC will find these symptoms bothersome, in which case the doctor may treat the PACs. Sometimes the PACs can indicate heart disease or an increased risk for other cardiac arrhythmias. In this case, the underlying cause is treated.
On the surface ECG, premature junctional contractions will appear as a normally shaped ventricular complex or QRS complex, not preceded by any atrial complex or P wave or preceded by an abnormal P wave with a shorter PR interval. Rarely, the abnormal P wave can follow the QRS.