Wandering atrial pacemaker

Cardiovascular Disease

Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023

Sick sinus syndrome may present with sinus pauses, inappropriate sinus tachycardias and bradycardias, and an intermittent wandering atrial pacemaker. A pacemaker may be required for severe chronic sick sinus syndrome with long pauses (>3 seconds).

Cardiac auscultation predicts mortality in elderly patients admitted for COVID-19

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Journal Information

Published in Hospital Practice, 2022

Noel Roig-Marín, Pablo Roig-Rico

After conducting cardiac auscultation, electrocardiograms were performed and they confirmed the presence of an arrhythmia. Different types of arrhythmias were recorded, such as those with multifocal atrial rhythm/wandering atrial pacemaker (Figure 1a). Another type of arrhythmia was one in which extrasystoles were present, as in the following figure in which premature ventricular contractions are observed (Figure 1B). Another type of arrhythmia registered was atrial fibrillation (Figure 1C), but this type of arrhythmia was largely associated with cardiac pathology already registered in the past. Therefore, atrial fibrillation was a less relevant finding, since most arrhythmias were not ex novo. Consequently, it was essential to include the variable of the presence of known cardiac arrhythmias in the multivariate analysis of the logistic regression. The ex novo arrhythmia that presented a higher mortality rate was multifocal atrial rhythm. Isolated ectopic beats had a more benign course and prognosis compared to multifocal atrial rhythm. No significant difference in mortality rate was detected between patients with known atrial fibrillation and the finding of ex novo atrial fibrillation; probably because the study is composed of a small population group.

Wandering atrial pacemaker

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Cardiovascular Disease

Cardiac auscultation predicts mortality in elderly patients admitted for COVID-19