Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Wandering Atrial Pacemaker


Related Terms

  • Abnormal Atrial Electrical Impulses

Differential Diagnosis

  • Atrioventricular (AV) junctional rhythm
  • Digitalis toxicity
  • Multifocal atrial arrhythmia

Specialists

  • Cardiovascular Internist

Factors Influencing Duration

There is generally no disability associated with this condition; however, it may be brought on by strenuous job activities such as lifting heavy objects.

Medical Codes

ICD-9-CM:
427.89 - Cardiac Dysrhythmias, Other Specified, Other; Rhythm Disorder: Coronary Sinus, Ectopic, Nodal; Wandering Pacemaker

Overview

Wandering atrial pacemaker is a condition in which the electrical impulse that triggers heart contractions does not originate from its normal location. Ordinarily, the beat is initiated from a nucleus of specialized muscle called the sinoatrial (SA) node. In wandering atrial pacemaker, the electrical impulse may also initiate from other sites in the atrium (upper chamber of the heart) instead.

Wandering atrial pacemaker is one of a number of possible variations (arrhythmias) in the heart's usual beat. It is usually a normal finding that occurs in association with sinus arrhythmias. It is generally considered benign and is usually transitory. Often it is encountered in association with respiratory effort or strain, due to increased vagal tone, for example during the act of lifting heavy weights. Thus, individuals in whom this condition might occur include construction workers, warehouse workers, janitors, and horticulturists or other professions in which digging is involved.

Source: Medical Disability Advisor



Diagnosis

History: Most individuals have no symptoms.

Physical exam: On auscultation via stethoscope, the heart rate is variable depending on the site of the atypical pacemaker, usually between 45 to 100 beats per minute, and the rhythm is irregular.

Tests: Diagnosis is confirmed by recording the electrical activity of the heart (electrocardiogram). The heart rate is variable depending on the site of the atypical pacemaker, usually between 45 to 100 beats per minute, and the rhythm is irregular.

Source: Medical Disability Advisor



Treatment

The heart generally returns to its normal rhythm without intervention, requiring no treatment.

Source: Medical Disability Advisor



Prognosis

In most individuals, the heart returns to its normal rhythm without assistance.

Source: Medical Disability Advisor



Complications

Complications are not usually associated with this condition.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

There are generally no work restrictions or accommodations associated with this condition.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Has diagnosis of wandering atrial pacemaker been confirmed through electrocardiogram? Is the individual experiencing any symptoms?
  • Have other, more dangerous arrhythmias been ruled out?

Regarding treatment:

  • Is individual involved in strenuous job activities, weightlifting, or other strenuous activities?
  • What modifications can be made to avoid triggering another episode of wandering atrial pacemaker?

Regarding prognosis:

  • Has the heart returned to its normal rhythm?
  • Does diagnosis need to be revisited?
  • Would individual benefit from evaluation by a specialist (cardiologist)?

Source: Medical Disability Advisor



References

General

Goldberger, A. L. Clinical Electrocardiography. 6th ed. St. Louis: Mosby, Inc., 1999.

Source: Medical Disability Advisor






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