P wave morphology

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Author(s) J.S.S.G. de Jong, MD, A. Bouhiouf, Msc
Moderator J.S.S.G. de Jong, MD
Supervisor
some notes about authorship

The p wave morphology can reveal right or left atrial stretch.

The P-wave morphology is best determined in leads II and V1 during sinus rhythm.

[edit] The normal P wave

Normal sinus rhythm with a positive p wave in leads I, II en AVF and a biphasic p wave in V1.
Normal sinus rhythm with a positive p wave in leads I, II en AVF and a biphasic p wave in V1.
An example of normal sinus rhythm.
An example of normal sinus rhythm.
Another example of normal sinus rhythm.
Another example of normal sinus rhythm.
Characteristics of a normal p wave:[1]
  • The maximal height of the P wave is 2.5 mm in leads II and / or III
  • The p wave is positive in II and AVF, and bifasic in V1
  • The p wave duration is usually shorter than 0.12 seconds

Elevation or depression of the PTa segment (the part between the p wave and the beginning of the QRS complex) can result from Atrial infarction or pericarditis.

If the p-wave is enlarged, the atria are enlarged.


[edit] References

  1. Spodick DH, Raju P, Bishop RL, and Rifkin RD. Operational definition of normal sinus heart rate. Am J Cardiol 1992 May 1; 69(14) 1245-6. pmid:1575201. PubMed 1575201 HubMed 1575201
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