Introduction
A 24-hour Holter recording is not a way of reassuring a subject that he/she has no rhythm disturbance, as the vast majority of such recordings show some disturbance of rhythm.1-7 Among the frequently occurring rhythm disturbances on Holter recordings we have noticed is multi-focal atrial rhythm. Multi-focal atrial tachycardia is a well-recognised rhythm disturbance in patients with acute exacerbations of chronic lung disease.8-9 Multi-focal atrial rhythm or ‘wandering atrial pacemaker’ is a less well-defined entity. The rhythm is characterised by a change of atrial focus and may be accompanied by a change in heart rate. When
