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The P wave is a summation wave generated by the depolarization front as it transits the atria. 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.
To make the diagnosis, there must be at least 3 different P-wave morphologies in a single ECG lead due to the shifting of the pacemaker in the atria. [1] This is different from normal sinus rhythm where one will see the same P-wave morphology through the same lead because each beat is started from the SA node. The P-wave is normally upright or ...
Right Atrial Enlargement (RAE) increases the p wave, representing atrial depolarization, on an ECG to an amplitude > 2.5mm in lead II, an abnormality referred to as p-pulmonale, likely due to weakened right atrial myocardium close to the Sinoatrial (SA) node.
P wave: The P wave represents depolarization of the atria. Atrial depolarization spreads from the SA node towards the AV node, and from the right atrium to the left atrium. The P wave is typically upright in most leads except for aVR; an unusual P wave axis (inverted in other leads) can indicate an ectopic atrial pacemaker. If the P wave is of ...
LAE is suggested by an electrocardiogram (ECG) that has a pronounced notch in the P wave. [7] However, if atrial fibrillation is present, a P wave would not be present. [ 8 ] In any case, LAE can be diagnosed and measured using an echocardiogram (ECHO) by measuring the left atrial volume (LAVI).
If the P wave is hidden that implies the atria depolarize at the same time as the ventricles. 2. There are inverted P waves prior to the QRS complex. This is because of retrograde flow to the atria causing depolarization prior to the ventricular contraction. Since the depolarization is occurring in the opposite direction, the P wave deflection ...
Since the premature beat initiates outside the sinoatrial node, the associated P wave appears different from those seen in normal sinus rhythm. Typically, the atrial impulse propagates normally through the atrioventricular node and into the cardiac ventricles , resulting in a normal, narrow QRS complex .
An example of an ECG tracing typical of uncommon AV nodal reentrant tachycardia. Highlighted in yellow is the P wave that falls after the QRS complex. Specialty: Cardiology: Symptoms: Palpitations, chest tightness, neck pulsation: Diagnostic method: electrocardiogram, electrophysiological study: Differential diagnosis