49 y/M, asymptomatic patient. What does this ECG show?
This ECG shows multiple P wave morphologies (≥3 different P waves) but a normal heart rate (60 to 100 beats per minute) which are considered as wandering atrial pacemaker. Each P wave morphology indicates a different site of atrial origin. If the heart rate was >100 bpm, we would call it multifocal atrial tachycardia.