Your 85 year old patient has a heart rate of 70 BPM. Analysis of the ECG reveals a slightly irregular rhythm with one P wave preceding each narrow QRS complex. The appearance of the P waves appears to change as often as from beat to beat. This is likely the result of:

Question

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The description of a slightly irregular rhythm with one P wave preceding each narrow QRS complex, where the appearance of the P waves changes as often as from beat to beat, suggests a changing pacemaker site within the atria. This means that the origin of the electrical impulses that initiate the heartbeats is moving around within the atria, leading to the variation in P wave appearance.

Your 85 Year Old Patient Has a Heart Rate of 70