U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Abnormal P wave

MedGen UID:
1638207
•Concept ID:
C4703432
•
Finding
HPO: HP:0031595

Definition

Any anomaly of the P wave of the EKG, which results from atrial depolarization. The P wave occurs when the sinoatrial node creates an action potential that depolarizes the atria. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAbnormal P wave

Professional guidelines

PubMed

P Wave Parameters and Indices: A Critical Appraisal of Clinical Utility, Challenges, and Future Research-A Consensus Document Endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology.
Chen LY, Ribeiro ALP, Platonov PG, Cygankiewicz I, Soliman EZ, Gorenek B, Ikeda T, Vassilikos VP, Steinberg JS, Varma N, Bayés-de-Luna A, Baranchuk A
Circ Arrhythm Electrophysiol 2022 Apr;15(4):e010435. Epub 2022 Mar 25 doi: 10.1161/CIRCEP.121.010435. PMID: 35333097Free PMC Article
Evaluation of the Seattle and International Criteria in elite Nigerian athletes.
Ilodibia TF, Odia JO
J Electrocardiol 2021 Sep-Oct;68:14-23. Epub 2021 Jul 7 doi: 10.1016/j.jelectrocard.2021.06.007. PMID: 34273803
Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes.
Jiang X, Quan X, Yang J, Zhou X, Hu A, Zhang Y
J Clin Hypertens (Greenwich) 2019 Mar;21(3):372-378. Epub 2019 Feb 1 doi: 10.1111/jch.13486. PMID: 30706989Free PMC Article

Recent clinical studies

Etiology

The characteristic of an abnormal p-wave axis in patients with atrial fibrillation.
Wakatsuki D, Asano T, Mase H, Kurata M, Onuki T, Suzuki H
J Electrocardiol 2022 Jul-Aug;73:1-7. Epub 2022 Apr 26 doi: 10.1016/j.jelectrocard.2022.04.003. PMID: 35524997
Secondhand smoke exposure is associated with abnormal P-wave axis.
Skipina TM, Patel N, Upadhya B, Soliman EZ
Public Health 2022 Apr;205:79-82. Epub 2022 Mar 2 doi: 10.1016/j.puhe.2022.01.026. PMID: 35247863Free PMC Article
Abnormal P-wave terminal force in lead V(1) is a marker for atrial electrical dysfunction but not structural remodelling.
Lebek S, Wester M, Pec J, Poschenrieder F, Tafelmeier M, Fisser C, Provaznik Z, Schopka S, Debl K, Schmid C, Buchner S, Maier LS, Arzt M, Wagner S
ESC Heart Fail 2021 Oct;8(5):4055-4066. Epub 2021 Jun 30 doi: 10.1002/ehf2.13488. PMID: 34196135Free PMC Article
Abnormal P-wave axis and myocardial ischemia development during mental stress.
Almuwaqqat Z, O'Neal WT, Hammadah M, Lima BB, Bremner JD, Soliman EZ, Shah AJ, Quyyumi AA, Vaccarino V
J Electrocardiol 2020 May-Jun;60:3-7. Epub 2020 Mar 3 doi: 10.1016/j.jelectrocard.2020.02.019. PMID: 32179275Free PMC Article
Abnormal P-Wave Axis and Ischemic Stroke: The ARIC Study (Atherosclerosis Risk In Communities).
Maheshwari A, Norby FL, Soliman EZ, Koene RJ, Rooney MR, O'Neal WT, Alonso A, Chen LY
Stroke 2017 Aug;48(8):2060-2065. Epub 2017 Jun 16 doi: 10.1161/STROKEAHA.117.017226. PMID: 28626057Free PMC Article

Diagnosis

Abnormal P-wave terminal force in lead V(1) is a marker for atrial electrical dysfunction but not structural remodelling.
Lebek S, Wester M, Pec J, Poschenrieder F, Tafelmeier M, Fisser C, Provaznik Z, Schopka S, Debl K, Schmid C, Buchner S, Maier LS, Arzt M, Wagner S
ESC Heart Fail 2021 Oct;8(5):4055-4066. Epub 2021 Jun 30 doi: 10.1002/ehf2.13488. PMID: 34196135Free PMC Article
Abnormal P-wave axis and myocardial ischemia development during mental stress.
Almuwaqqat Z, O'Neal WT, Hammadah M, Lima BB, Bremner JD, Soliman EZ, Shah AJ, Quyyumi AA, Vaccarino V
J Electrocardiol 2020 May-Jun;60:3-7. Epub 2020 Mar 3 doi: 10.1016/j.jelectrocard.2020.02.019. PMID: 32179275Free PMC Article
Abnormal P-Wave Axis and Ischemic Stroke: The ARIC Study (Atherosclerosis Risk In Communities).
Maheshwari A, Norby FL, Soliman EZ, Koene RJ, Rooney MR, O'Neal WT, Alonso A, Chen LY
Stroke 2017 Aug;48(8):2060-2065. Epub 2017 Jun 16 doi: 10.1161/STROKEAHA.117.017226. PMID: 28626057Free PMC Article
Atrial myocardial infarction: A tale of the forgotten chamber.
Lu ML, De Venecia T, Patnaik S, Figueredo VM
Int J Cardiol 2016 Jan 1;202:904-9. Epub 2015 Oct 9 doi: 10.1016/j.ijcard.2015.10.070. PMID: 26485186
Prognostic significance of abnormal P wave morphology and PR-segment displacement after ST-elevation myocardial infarction.
Lu ML, Nwakile C, Bhalla V, De Venecia T, Shah M, Figueredo VM
Int J Cardiol 2015 Oct 15;197:216-21. Epub 2015 Jun 24 doi: 10.1016/j.ijcard.2015.06.055. PMID: 26148766

Therapy

The predictive value of abnormal P-wave axis for the detection of incident atrial fibrillation: A systematic review with meta-analysis.
Chattopadhyay RK, Chousou PA, Mukherjee T, Pugh PJ, Vassiliou VS
PLoS One 2022;17(12):e0278527. Epub 2022 Dec 1 doi: 10.1371/journal.pone.0278527. PMID: 36454918Free PMC Article
Secondhand smoke exposure is associated with abnormal P-wave axis.
Skipina TM, Patel N, Upadhya B, Soliman EZ
Public Health 2022 Apr;205:79-82. Epub 2022 Mar 2 doi: 10.1016/j.puhe.2022.01.026. PMID: 35247863Free PMC Article
Predictive role of P-wave axis abnormalities in secondary cardiovascular prevention.
Lazzeroni D, Bini M, Camaiora U, Castiglioni P, Moderato L, Ugolotti PT, Brambilla L, Brambilla V, Coruzzi P
Eur J Prev Cardiol 2017 Dec;24(18):1994-1999. Epub 2017 Oct 3 doi: 10.1177/2047487317734892. PMID: 28969493
Relationship between abnormal P-wave terminal force in lead V(1) and left ventricular diastolic dysfunction in hypertensive patients: the LIFE study.
Tanoue MT, Kjeldsen SE, Devereux RB, Okin PM
Blood Press 2017 Apr;26(2):94-101. Epub 2016 Aug 9 doi: 10.1080/08037051.2016.1215765. PMID: 27601135
Abnormal P-wave morphology is a predictor of atrial fibrillation development and cardiac death in MADIT II patients.
Holmqvist F, Platonov PG, McNitt S, Polonsky S, Carlson J, Zareba W, Moss AJ; MADIT II Investigators
Ann Noninvasive Electrocardiol 2010 Jan;15(1):63-72. doi: 10.1111/j.1542-474X.2009.00341.x. PMID: 20146784Free PMC Article

Prognosis

Abnormal P-wave terminal force in lead V(1) is a marker for atrial electrical dysfunction but not structural remodelling.
Lebek S, Wester M, Pec J, Poschenrieder F, Tafelmeier M, Fisser C, Provaznik Z, Schopka S, Debl K, Schmid C, Buchner S, Maier LS, Arzt M, Wagner S
ESC Heart Fail 2021 Oct;8(5):4055-4066. Epub 2021 Jun 30 doi: 10.1002/ehf2.13488. PMID: 34196135Free PMC Article
Association of Abnormal P-Wave Indices With Dementia and Cognitive Decline Over 25 Years: ARIC-NCS (The Atherosclerosis Risk in Communities Neurocognitive Study).
Gutierrez A, Norby FL, Maheshwari A, Rooney MR, Gottesman RF, Mosley TH, Lutsey PL, Oldenburg N, Soliman EZ, Alonso A, Chen LY
J Am Heart Assoc 2019 Dec 17;8(24):e014553. Epub 2019 Dec 13 doi: 10.1161/JAHA.119.014553. PMID: 31830872Free PMC Article
Abnormal P-Wave Axis and Ischemic Stroke: The ARIC Study (Atherosclerosis Risk In Communities).
Maheshwari A, Norby FL, Soliman EZ, Koene RJ, Rooney MR, O'Neal WT, Alonso A, Chen LY
Stroke 2017 Aug;48(8):2060-2065. Epub 2017 Jun 16 doi: 10.1161/STROKEAHA.117.017226. PMID: 28626057Free PMC Article
Relationship between abnormal P-wave terminal force in lead V(1) and left ventricular diastolic dysfunction in hypertensive patients: the LIFE study.
Tanoue MT, Kjeldsen SE, Devereux RB, Okin PM
Blood Press 2017 Apr;26(2):94-101. Epub 2016 Aug 9 doi: 10.1080/08037051.2016.1215765. PMID: 27601135
Prognostic significance of abnormal P wave morphology and PR-segment displacement after ST-elevation myocardial infarction.
Lu ML, Nwakile C, Bhalla V, De Venecia T, Shah M, Figueredo VM
Int J Cardiol 2015 Oct 15;197:216-21. Epub 2015 Jun 24 doi: 10.1016/j.ijcard.2015.06.055. PMID: 26148766

Clinical prediction guides

Relation of Electrocardiographic Abnormal P-Wave Axis With Stroke Mortality in the General Population.
Ahmad MI, Tk LA, Anees MA, Chen LY, Soliman EZ
Am J Cardiol 2022 Oct 1;180:59-64. Epub 2022 Aug 6 doi: 10.1016/j.amjcard.2022.06.051. PMID: 35945040
The characteristic of an abnormal p-wave axis in patients with atrial fibrillation.
Wakatsuki D, Asano T, Mase H, Kurata M, Onuki T, Suzuki H
J Electrocardiol 2022 Jul-Aug;73:1-7. Epub 2022 Apr 26 doi: 10.1016/j.jelectrocard.2022.04.003. PMID: 35524997
Abnormal P-wave terminal force in lead V(1) is a marker for atrial electrical dysfunction but not structural remodelling.
Lebek S, Wester M, Pec J, Poschenrieder F, Tafelmeier M, Fisser C, Provaznik Z, Schopka S, Debl K, Schmid C, Buchner S, Maier LS, Arzt M, Wagner S
ESC Heart Fail 2021 Oct;8(5):4055-4066. Epub 2021 Jun 30 doi: 10.1002/ehf2.13488. PMID: 34196135Free PMC Article
Refining Prediction of Atrial Fibrillation-Related Stroke Using the P(2)-CHA(2)DS(2)-VASc Score.
Maheshwari A, Norby FL, Roetker NS, Soliman EZ, Koene RJ, Rooney MR, O'Neal WT, Shah AM, Claggett BL, Solomon SD, Alonso A, Gottesman RF, Heckbert SR, Chen LY
Circulation 2019 Jan 8;139(2):180-191. doi: 10.1161/CIRCULATIONAHA.118.035411. PMID: 30586710Free PMC Article
Relationship between abnormal P-wave terminal force in lead V(1) and left ventricular diastolic dysfunction in hypertensive patients: the LIFE study.
Tanoue MT, Kjeldsen SE, Devereux RB, Okin PM
Blood Press 2017 Apr;26(2):94-101. Epub 2016 Aug 9 doi: 10.1080/08037051.2016.1215765. PMID: 27601135

Recent systematic reviews

The predictive value of abnormal P-wave axis for the detection of incident atrial fibrillation: A systematic review with meta-analysis.
Chattopadhyay RK, Chousou PA, Mukherjee T, Pugh PJ, Vassiliou VS
PLoS One 2022;17(12):e0278527. Epub 2022 Dec 1 doi: 10.1371/journal.pone.0278527. PMID: 36454918Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...