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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

Treatment with recombinant Sirt1 rewires the cardiac lipidome and rescues diabetes-related metabolic cardiomyopathy.
Costantino S, Mengozzi A, Velagapudi S, Mohammed SA, Gorica E, Akhmedov A, Mongelli A, Pugliese NR, Masi S, Virdis A, Hülsmeier A, Matter CM, Hornemann T, Melina G, Ruschitzka F, Luscher TF, Paneni F
Cardiovasc Diabetol 2023 Nov 13;22(1):312. doi: 10.1186/s12933-023-02057-2. PMID: 37957697Free PMC Article
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

Recent clinical studies

Etiology

Relationship between abnormal P-wave axis, chronic obstructive pulmonary disease and mortality in the general population.
Kazibwe R, Ahmad MI, Luqman-Arafat TK, Chen H, Yeboah J, Soliman EZ
J Electrocardiol 2023 Jul-Aug;79:100-107. Epub 2023 Apr 3 doi: 10.1016/j.jelectrocard.2023.03.085. PMID: 37030109
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 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

Relationship between abnormal P-wave axis, chronic obstructive pulmonary disease and mortality in the general population.
Kazibwe R, Ahmad MI, Luqman-Arafat TK, Chen H, Yeboah J, Soliman EZ
J Electrocardiol 2023 Jul-Aug;79:100-107. Epub 2023 Apr 3 doi: 10.1016/j.jelectrocard.2023.03.085. PMID: 37030109
P-wave parameters and their association with thrombi and spontaneous echo contrast in the left atrial appendage.
Kreimer F, Backhaus JF, Krogias C, Pflaumbaum A, Mügge A, Gotzmann M
Clin Cardiol 2023 Apr;46(4):397-406. Epub 2023 Feb 17 doi: 10.1002/clc.23980. PMID: 36808747Free 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

Therapy

Identification of Brugada syndrome based on P-wave features: an artificial intelligence-based approach.
Zanchi B, Faraci FD, Gharaviri A, Bergonti M, Monga T, Auricchio A, Conte G
Europace 2023 Nov 2;25(11) doi: 10.1093/europace/euad334. PMID: 37944131Free PMC Article
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
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

Interrelationships among abnormal P-wave axis, metabolic syndrome and its components, and mortality in US adults.
Wang Y, Zhang T, Zhang Y, Huang Z, Guo Q, Lan C, Deng L, Liu Y, Wu M, Yu P, Lin L, Liao Y
J Electrocardiol 2024 May-Jun;84:137-144. Epub 2024 Apr 26 doi: 10.1016/j.jelectrocard.2024.04.004. PMID: 38696980
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 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
Prevalence and prognosis of ECG abnormalities in normotensive and hypertensive individuals.
Lehtonen AO, Puukka P, Varis J, Porthan K, Tikkanen JT, Nieminen MS, Huikuri HV, Anttila I, Nikus K, Kähönen M, Jula A, Niiranen TJ
J Hypertens 2016 May;34(5):959-66. doi: 10.1097/HJH.0000000000000882. PMID: 26886566
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

Relationship between abnormal P-wave axis, chronic obstructive pulmonary disease and mortality in the general population.
Kazibwe R, Ahmad MI, Luqman-Arafat TK, Chen H, Yeboah J, Soliman EZ
J Electrocardiol 2023 Jul-Aug;79:100-107. Epub 2023 Apr 3 doi: 10.1016/j.jelectrocard.2023.03.085. PMID: 37030109
P-wave parameters and their association with thrombi and spontaneous echo contrast in the left atrial appendage.
Kreimer F, Backhaus JF, Krogias C, Pflaumbaum A, Mügge A, Gotzmann M
Clin Cardiol 2023 Apr;46(4):397-406. Epub 2023 Feb 17 doi: 10.1002/clc.23980. PMID: 36808747Free PMC Article
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

Recent systematic reviews

ECG predictors of AF: A systematic review (predicting AF in ischaemic stroke-PrAFIS).
Berry-Noronha A, Bonavia L, Song E, Grose D, Johnson D, Maylin E, Oqueli E, Sahathevan R
Clin Neurol Neurosurg 2024 Feb;237:108164. Epub 2024 Feb 11 doi: 10.1016/j.clineuro.2024.108164. PMID: 38377651
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

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