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Absent P wave

MedGen UID:
324892
Concept ID:
C1837847
Finding
Synonyms: Absence of P wave on electrocardiography; Absent P waves
 
HPO: HP:0033122

Definition

The P wave that normally precedes each QRS complex by a fixed PR interval of 120 to 200 milliseconds is not present. [from HPO]

Term Hierarchy

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

Conditions with this feature

Sick sinus syndrome 1
MedGen UID:
325270
Concept ID:
C1837845
Disease or Syndrome
The term 'sick sinus syndrome' encompasses a variety of conditions caused by sinus node dysfunction. The most common clinical manifestations are syncope, presyncope, dizziness, and fatigue. Electrocardiogram typically shows sinus bradycardia, sinus arrest, and/or sinoatrial block. Episodes of atrial tachycardias coexisting with sinus bradycardia ('tachycardia-bradycardia syndrome') are also common in this disorder. SSS occurs most often in the elderly associated with underlying heart disease or previous cardiac surgery, but can also occur in the fetus, infant, or child without heart disease or other contributing factors, in which case it is considered to be a congenital disorder (Benson et al., 2003). Genetic Heterogeneity of Sick Sinus Syndrome Sick sinus syndrome-2 (SSS2; 163800) is caused by mutation in the HCN4 gene (605206). Susceptibility to sick sinus syndrome-3 (SSS3; 614090) is influenced by variation in the MYH6 gene (160710). Sick sinus syndrome-4 (SSS4; 619464) is caused by mutation in the GNB2 gene (139390).
Atrial standstill 2
MedGen UID:
816731
Concept ID:
C3810401
Disease or Syndrome
Atrial standstill (AS) is a rare condition characterized by the absence of electrical and mechanical activity in the atria. On surface ECG, AS is distinguished by bradycardia, junctional (usually narrow complex) escape rhythm, and absence of the P wave. Nearly 50% of patients with AS experience syncope. AS can be persistent or transient, and diffuse or partial (summary by Fazelifar et al., 2005).
Emery-Dreifuss muscular dystrophy 1, X-linked
MedGen UID:
1720295
Concept ID:
C5243475
Disease or Syndrome
Emery-Dreifuss muscular dystrophy inherited in an X-linked recessive pattern and caused by mutations in the EMD gene, encoding emerin.

Professional guidelines

PubMed

Diederich NJ, Paolini V, Vaillant M
Acta Neurol Scand 2009 Nov;120(5):308-13. Epub 2009 May 21 doi: 10.1111/j.1600-0404.2009.01167.x. PMID: 19485952
Vereckei A, Duray G, Szénási G, Altemose GT, Miller JM
Heart Rhythm 2008 Jan;5(1):89-98. Epub 2007 Sep 20 doi: 10.1016/j.hrthm.2007.09.020. PMID: 18180024
De Capua B, De Felice C, Costantini D, Bagnoli F, Passali D
Acta Otorhinolaryngol Ital 2003 Feb;23(1):16-20. PMID: 12812130

Recent clinical studies

Etiology

Kippe YD, Adam M, Finck A, Moran JK, Schouler-Ocak M, Bermpohl F, Gutwinski S, Goldschmidt T
Eur Arch Psychiatry Clin Neurosci 2023 Mar;273(2):311-323. Epub 2022 Sep 7 doi: 10.1007/s00406-022-01486-6. PMID: 36071277Free PMC Article
Kudchadkar SR, Berger J, Patel R, Barnes S, Twose C, Walker T, Mitchell R, Song J, Anton B, Punjabi NM
Cochrane Database Syst Rev 2022 Jun 15;6(6):CD012908. doi: 10.1002/14651858.CD012908.pub2. PMID: 35703367Free PMC Article
Peltier MR, Roberts W, Verplaetse TL, Zakiniaeiz Y, Burke C, Moore KE, McKee SA
J Dual Diagn 2022 Jan-Mar;18(1):11-20. Epub 2021 Dec 29 doi: 10.1080/15504263.2021.2016027. PMID: 34965199Free PMC Article
Bigler MR, Zimmermann P, Papadis A, Seiler C
J Electrocardiol 2021 Jan-Feb;64:50-57. Epub 2020 Dec 5 doi: 10.1016/j.jelectrocard.2020.11.018. PMID: 33316551
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E
JAMA 2000 Aug 16;284(7):835-42. doi: 10.1001/jama.284.7.835. PMID: 10938172

Diagnosis

Aizawa Y, Ohashi N, Kawamura A, Ogawa S, Aizawa Y
Pacing Clin Electrophysiol 2023 Aug;46(8):868-874. Epub 2023 Jul 18 doi: 10.1111/pace.14787. PMID: 37461879
Peltier MR, Roberts W, Verplaetse TL, Zakiniaeiz Y, Burke C, Moore KE, McKee SA
J Dual Diagn 2022 Jan-Mar;18(1):11-20. Epub 2021 Dec 29 doi: 10.1080/15504263.2021.2016027. PMID: 34965199Free PMC Article
Garcovich M, Faccia M, Di Stasio E, Riccardi L, Zocco MA, Ainora ME, Vecchio FM, Mingrone G, Gasbarrini A, Pompili M
J Ultrasound Med 2022 Apr;41(4):877-886. Epub 2021 Jun 25 doi: 10.1002/jum.15767. PMID: 34170033
Bigler MR, Zimmermann P, Papadis A, Seiler C
J Electrocardiol 2021 Jan-Feb;64:50-57. Epub 2020 Dec 5 doi: 10.1016/j.jelectrocard.2020.11.018. PMID: 33316551
Vereckei A, Duray G, Szénási G, Altemose GT, Miller JM
Heart Rhythm 2008 Jan;5(1):89-98. Epub 2007 Sep 20 doi: 10.1016/j.hrthm.2007.09.020. PMID: 18180024

Therapy

Aizawa Y, Ohashi N, Kawamura A, Ogawa S, Aizawa Y
Pacing Clin Electrophysiol 2023 Aug;46(8):868-874. Epub 2023 Jul 18 doi: 10.1111/pace.14787. PMID: 37461879
Kudchadkar SR, Berger J, Patel R, Barnes S, Twose C, Walker T, Mitchell R, Song J, Anton B, Punjabi NM
Cochrane Database Syst Rev 2022 Jun 15;6(6):CD012908. doi: 10.1002/14651858.CD012908.pub2. PMID: 35703367Free PMC Article
Liu H, Li M, Li C, Wang Z, Lu Q, Gu Z, Qi X, Ju W, Chen H, Zhang Y, Zhang F, Gu K, Yang G, Wang Z, Feng D, Lip GYH, Chen M
Stroke 2021 Mar;52(3):1074-1078. Epub 2021 Jan 28 doi: 10.1161/STROKEAHA.120.031666. PMID: 33504191
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E
JAMA 2000 Aug 16;284(7):835-42. doi: 10.1001/jama.284.7.835. PMID: 10938172
Raimo EB, Roemer RA, Moster M, Shan Y
Biol Psychiatry 1999 Jun 1;45(11):1523-6. doi: 10.1016/s0006-3223(98)00257-1. PMID: 10356638

Prognosis

Kippe YD, Adam M, Finck A, Moran JK, Schouler-Ocak M, Bermpohl F, Gutwinski S, Goldschmidt T
Eur Arch Psychiatry Clin Neurosci 2023 Mar;273(2):311-323. Epub 2022 Sep 7 doi: 10.1007/s00406-022-01486-6. PMID: 36071277Free PMC Article
Alicuben ET, Bildzukewicz N, Samakar K, Katkhouda N, Dobrowolsky A, Sandhu K, Lipham JC
Surg Endosc 2019 May;33(5):1650-1653. Epub 2018 Sep 24 doi: 10.1007/s00464-018-6456-x. PMID: 30251140
Vereckei A, Duray G, Szénási G, Altemose GT, Miller JM
Heart Rhythm 2008 Jan;5(1):89-98. Epub 2007 Sep 20 doi: 10.1016/j.hrthm.2007.09.020. PMID: 18180024
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E
JAMA 2000 Aug 16;284(7):835-42. doi: 10.1001/jama.284.7.835. PMID: 10938172
Raimo EB, Roemer RA, Moster M, Shan Y
Biol Psychiatry 1999 Jun 1;45(11):1523-6. doi: 10.1016/s0006-3223(98)00257-1. PMID: 10356638

Clinical prediction guides

Aizawa Y, Ohashi N, Kawamura A, Ogawa S, Aizawa Y
Pacing Clin Electrophysiol 2023 Aug;46(8):868-874. Epub 2023 Jul 18 doi: 10.1111/pace.14787. PMID: 37461879
Kudchadkar SR, Berger J, Patel R, Barnes S, Twose C, Walker T, Mitchell R, Song J, Anton B, Punjabi NM
Cochrane Database Syst Rev 2022 Jun 15;6(6):CD012908. doi: 10.1002/14651858.CD012908.pub2. PMID: 35703367Free PMC Article
Ogata H, Zhang X, Inamizu S, Yamashita KI, Yamasaki R, Matsushita T, Isobe N, Hiwatashi A, Tobimatsu S, Kira JI
Ann Clin Transl Neurol 2020 Nov;7(11):2297-2309. Epub 2020 Oct 20 doi: 10.1002/acn3.51220. PMID: 33080117Free PMC Article
Vereckei A, Duray G, Szénási G, Altemose GT, Miller JM
Heart Rhythm 2008 Jan;5(1):89-98. Epub 2007 Sep 20 doi: 10.1016/j.hrthm.2007.09.020. PMID: 18180024
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E
JAMA 2000 Aug 16;284(7):835-42. doi: 10.1001/jama.284.7.835. PMID: 10938172

Recent systematic reviews

Kudchadkar SR, Berger J, Patel R, Barnes S, Twose C, Walker T, Mitchell R, Song J, Anton B, Punjabi NM
Cochrane Database Syst Rev 2022 Jun 15;6(6):CD012908. doi: 10.1002/14651858.CD012908.pub2. PMID: 35703367Free PMC Article
Mustafa HJ, Javinani A, Goetzinger K, Aghajani F, Harman C, Shamshirsaz AA, Sanz Cortes M, Donepudi RV, Krispin E, Nassr AA, Espinoza J, Belfort MA, Turan OM
Am J Obstet Gynecol 2022 Jun;226(6):843.e1-843.e28. Epub 2022 Mar 4 doi: 10.1016/j.ajog.2022.02.035. PMID: 35257668

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