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P wave (electrocardiography)

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Title: P wave (electrocardiography)  
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Subject: Electrocardiography, Sinus rhythm, Hyperkalemia, Supraventricular tachycardia, P-wave, QRS complex, Premature atrial contraction, Bifid, Wandering pacemaker, Junctional ectopic tachycardia
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P wave (electrocardiography)

P wave in the ECG represents atrial depolarization, which causes atrial contraction.

Absence of the P wave may indicate:

Amplitude

Peaked p waves (>2.5mm) indicate right atrial enlargement(P pulmonale).[1]

A P wave with increased amplitude can indicate hypokalemia.[2] It can also indicate right atrial enlargement.[3]

A P wave with decreased amplitude can indicate hyperkalemia.

Morphology

Bifid p waves indicate left atrial hypertrophy (P mitrale),[1] while a saw tooth formed P wave may indicate atrial flutter.

If P waves are not clearly delineated in the surface ECG, Lewis lead may be used to better visualize P waves.

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References

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