Step 3 - P wave Morphology (Shape) - Cardiac Rhythms.


Description

  • The lead most commonly referenced in cardiac monitoring is lead II.
  • For the purposes of this training module, lead two will specifically be referenced unless otherwise specified.
  • The P wave in lead II in a normal heart is typically rounded and upright in appearance.
  • Changes in shape must be reported. This can be an indicator that the locus of stimulation is changing or the pathway taken is changing.
  • P waves may come in a variety of morphologies i.e. rounded and upright, peaked, flattened, notched, biphasic (second complex, pictured), inverted and even buried or absent!
  • Remember to describe the shape. This can be very important to the physician when diagnosing the patient.
analysis ecg image 110


P Wave Practice 1

analysis ecg image 111

Analyze this tracing. Describe the P waves.

Reveal Answer Upright and uniform


P Wave Practice 2

analysis ecg image 111

Analyze this tracing. Describe the P waves.

Reveal Answer Variable, upright, inverted and absent





Authors and Reviewers

Authored by Thomas O'Brien
Medically reviewed by Dr. Jonathan Keroes, MD, Cardiology
Last Update: 11/8/2020



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