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How Should Wandering Atrial Pacemaker Arrhythmia In Which You Experience Slow And Fast Heart Rate Be Medically Addressed?

Posted on Tue, 21 Dec 2021

Question: I had to have an EKG prior to a sedated MRI. Just got my results and don't understand them. My follow up appt isn't until mid July. Not sure if this is an emergent situation I should call me GP about.
Measurements
Intervals Axis
Rate: 98 P: 0
PR: 196 QRS: 48
QRSD: 86 T: 51
QT: 401
QTc: 513

Interpretive Statements
WANDERING PACEMAKER
PROLONGED QT INTERVAL
Compared to ECG 04/12/2017 04:11:53
Wandering atrial pacemaker now present
Prolonged QT interval now present
Sinus rhythm no longer present

Answered by Dr. Bhanu Partap (40 minutes later)

Brief Answer:
Kindly upload the reports

Detailed Answer:

Hello,

I would like to tell you that all these values are machine interpreted results which come printed on the ECG paper and are not always reliable. So its important to have a look at the ECG itself for proper interpretation and opinion.

So kindly upload the images of both of your ECG's after labeling them which one is old n which is fresh.

Also I would like to know about your medical history like Diabetes, Hypertension or any other heart related issue or other medical illness if you have any. Also any medicine which you are taking.

Kind regards
Dr Bhanu partap

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Bhanu Partap (58 minutes later)

I don't have access to the graphs - just the reports.

I am 63, 5' 6", 250 lbs. I am a smoker - 1 pack a day. Alcohol use is a glass of wine at dinner.

I take

Lyrica 200 mg 3X a day
Zanaflex 6 mg 3X a day
Prozac 40mg 2 once a day
Losartan/HCTZ 50/12.5 mg once a day
Celebrex 200 mg 2X a day
CoQ10 300 mg once a day
Potassium 99 mg once a day
Magnesium 100 mg once a day
Lipitor 40mg once a day
Prevacid 15 mg once a day
Oxycodone 5 mg PRN

I have arthritis, 6 ruptured discs in my back, bad knees, bad shoulders.

Here are the last 3 EKG reports.

11/7/11     SINUS BRADYCARDIA

4/12/17     Test Date: 2017-04-12 Department: ER MRN: 0000 Room: GR 27 Gender: F Technician: 34939 DOB: 1954-09-05 Order #: 0000 Measurements Intervals Axis Rate: 73 P: 57 PR: 156 QRS: 24 QRSD: 82 T: 61 QT: 424 QTc: 468 Interpretive Statements SINUS RHYTHM Compared to ECG 02/05/2016 13:23:06 Sinus bradycardia no longer present

6/18/18     Test Date: 2018-06-18 Department: EKG MRN: 0000 Room: Gender: Female Technician: SRS DOB: 1954-09-05 Order #: 0000 Measurements Intervals Axis Rate: 98 P: 0 PR: 196 QRS: 48 QRSD: 86 T: 51 QT: 401 QTc: 513 Interpretive Statements WANDERING PACEMAKER PROLONGED QT INTERVAL Compared to ECG 04/12/2017 04:11:53 Wandering atrial pacemaker now present Prolonged QT interval now present Sinus rhythm no longer present

Answered by Dr. Bhanu Partap (20 hours later)

Brief Answer:
Hello Again

Detailed Answer:
After carefully going through your ecg measurements ( not rhythm) and all your medication I would like to tell you that you are having wandering atrial pacemaker arrhythmia in which you experience slow and fast heart rate. And you are not taking any medicine which cause you WAP.

It generally doesn’t require any treatment as it doesn’t causes you any symptoms and is accidental finding, like in your case accidentally found during MRI. Only requirement is to find out that you don’t have any other serious arrhythmia along with this which I can’t tell without having a look on your ECG .

You can consult a physician if you experience any symptoms like palpitations or unusual heart beat and no symptoms then there is no urgency , you can continue with your medication and routine work.

I’ll only recommend you to quit smoking n drinking because both has serious effects on your heart health.

Hopefully this information will answer your query.

Kind Regards
Dr Bhanu Partap

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T