This EKG was done as "preop" on healthy 26 year old asymptomatic patient for an ear surgery.
+ EKG Interpretation
Dr. Ohlbaum's Explanation
I want to look at the rhythm. Is it regular? No it is not. Is it fast or slow? Kind of medium. Are there P waves? Yes, there are, but are they the SAME P waves? No, the P waves are all different. There are easily 3 different P waves➔ 3 different PP and RR intervals. This is a wandering atrial pacemaker.
Young people often have a wandering atrial pacemaker when their sinus rate is slow. Sinus rate varies with breathing (sinus arrhythmia, often more prominent in young people), and if rate on low side to begin with it will drop down below the intrinsic rate of low atrial or junctional sites. But this one is NOT that slow so I don't have a great explanation.
The EKG is otherwise normal.