What causes the different P wave morphologies in an ECG tracing that shows wandering atrial pacemaker?

Question

Quizplus · Accepted Answer

Wandering atrial pacemaker occurs when there are multiple locations within the atria that generate electrical impulses, resulting in P waves with varying morphologies. These varying sites of ectopic impulses can cause the P wave to appear differently in terms of shape, amplitude, and duration. The strength of the atrial contraction caused by each impulse and the rate at which the ectopic impulses are generated could also vary but they would not cause the different P wave morphologies in this condition. The morphology of the resulting QRS complexes is also unrelated to the wandering atrial pacemaker.

What Causes the Different P Wave Morphologies in an ECG