P Wave Morphology
| «Step 4:Heart axis | Step 6: QRS morphology» |
| 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 Normal P wave
The P wave morphology can reveal right or left atrial stretch or atrial arrhythmias and is best determined in leads II and V1 during 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 shorter than 0.12 seconds
The abnormal P wave
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.
If the P wave is inverted, it is most likely an ectopic atrial rhythm not originating from the sinus node.
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