AFIB Pacemaker Pulmonary 
Dr. Smith's ECG Blog
JANUARY 22, 2020
This middle-aged patient presented with SOB, weakness, and mild pulmonary edema. She had a permanent pacemaker implanted. After pacer AND conversion to sinus rhythm: Computer diagnosis: IMPRESSION ELECTRONIC VENTRICULAR PACEMAKER ABNORMAL RHYTHM ECG What is missing from this interpretation? This shows atrial fibrillation.
Ken Grauer, MD
FEBRUARY 28, 2023
As a result, in order to differentiate MAT from the much more commonly encountered irregularly irregular rhythm ( which is AFib ) — we need to be certain we are seeing multiple different P wave morphologies that are constantly changing. MAT is not a Wandering Pacemaker. MAT almost always occurs in one of 2 common predisposing settings.
Ken Grauer, MD
JULY 9, 2023
ECG Blog #65 — for an example of MAT in a patient with chronic pulmonary disease ( plus more on the differential diagnosis of MAT ). ECG Blog #200 — for an example of Wandering Atrial Pacemaker. ECG Blog #71 — Regarding the Ashman Phenomenon with AFib. ECG Blog #199 and ECG Blog #366 — for Review of M AT.
Dr. Smith's ECG Blog
JANUARY 5, 2020
MAT has at least 3 distinct P-wave morphologies, but there is no single dominant pacemaker (i.e., AFib is the irregularly irregular rhythm that is most commonly confused with MAT — and , AFib is much, much, much more common than true MAT. The reasons for overlooking this arrhythmia are simple: True MAT is not a common rhythm.
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