![]() With either of these rhythms, if the ventricular rate is fast, the fibrillatory or flutter waves can easily be misinterpreted as P waves.Ībsence of the P wave with a flat baseline may indicate: If the baseline has a totally irregular form, this suggests fibrillatory waves of atrial fibrillation or possibly artefact a saw tooth shaped baseline suggests the flutter waves of atrial flutter. This appears particularly commonly in exacerbations of chronic obstructive lung disease. at least two) ectopic foci, and is called multifocal (or more correctly, multiform) atrial rhythm if the rate is ≤100) or multifocal atrial tachycardia if the rate is over 100. This is taken as evidence of multiple (i.e. If at least three different shaped P waves can be seen in a given ECG lead tracing, this implies that even if one of them arises from the SA node, at least two others are arising elsewhere. P-wave changes in left and right atrial hypertrophyīifid P waves (known as P mitrale) indicate left-atrial abnormality - e.g. Ī P wave with decreased amplitude can indicate hyperkalemia. ![]() It can also indicate right atrial enlargement. Ī P wave with increased amplitude can indicate hypokalemia. Peaked P waves (> 0.25 mV) suggest right atrial enlargement, cor pulmonale, ( P pulmonale rhythm), but have a low predictive value (~20%). Pathology Characteristic peaked P wave of cor pulmonale Depolarization originating elsewhere in the atria (atrial ectopics) result in P waves with a different morphology from normal. The depolarization front is carried through the atria along semi-specialized conduction pathways including Bachmann's bundle resulting in uniform shaped waves. Normally the right atrium depolarizes slightly earlier than left atrium since the depolarization wave originates in the sinoatrial node, in the high right atrium and then travels to and through the left atrium. The P wave is a summation wave generated by the depolarization front as it transits the atria. JSTOR ( February 2016) ( Learn how and when to remove this template message).Unsourced material may be challenged and removed.įind sources: "P wave" electrocardiography – news Please help improve this article by adding citations to reliable sources. This article needs additional citations for verification.
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