Wandering Atrial Pacemaker

Medically Reviewed by James Beckerman, MD, FACC on November 01, 2022
3 min read

A wandering atrial pacemaker is a rare form of a condition called arrhythmia. That's a problem with your heartbeat. It can happen anytime, even when you’re sleeping.

It’s usually nothing to worry about. But in some people, it can lead to atrial fibrillation (AFib), a type of irregular heartbeat that can raise your chances of a stroke.

The upper right part of your heart has a group of cells called the sinoatrial (SA) node. Normally, the SA node sets the beat of your heart. It speeds up when you exercise or feel emotional, and slows down when you sleep. Ordinarily, your SA node is in complete control of the pace of your heartbeat.

When you have a wandering atrial pacemaker, control of your heartbeat shifts from your SA node to other parts of your atria, the two upper chambers of your heart. When that happens and your heart continues to beat at a normal rate, you have a wandering atrial pacemaker.

You probably won't feel anything out of the ordinary. Sometimes, you might feel your heart beating faster, fluttering, or like it’s flopping around in an unpredictable way. In rare cases, you could also feel:

  • Fatigue
  • Breathlessness
  • Dizziness
  • Tightness or pressure in your chest

If you feel those changes in your heartbeat along with any of the symptoms above, call your doctor.

Some conditions can give you a greater chance of getting a wandering atrial pacemaker. They include:

A reaction to medication you take could also bring one.

A wandering atrial pacemaker is usually found with an electrocardiogram (EKG or ECG). It's a test that lets your doctor see a record of the electrical signals in your heart.

If the irregular rhythm only happens now and then, your doctor may ask you to monitor your heartbeat with a smartphone, smartwatch, or something called a Holter monitor, a wearable device that measures your heartbeats for a day or two.

Because a wandering atrial pacemaker is rare, it’s common for doctors to think that it's atrial fibrillation (AFib).

Because it doesn’t usually cause serious symptoms, you usually don't need treatment for a wandering atrial pacemaker.

But if your chest hurts or your heartbeat is racing, your doctor may treat any underlying conditions you might have. If you have other symptoms in addition to a problem with your heart that you can feel, your doctor may prescribe a medication called a beta-blocker to help get your heartbeat back to normal.

If you think you might have a wandering atrial pacemaker, it’s important to let your doctor know.

They'll make sure that you don’t have a similar condition called multifocal atrial tachycardia, which can cause a lot of the same symptoms. That's when your atria send too many signals.

If your doctor says you have multifocal atrial tachycardia, they will talk with you about treatment options.