What does it mean to have no p wave in an …

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    If it’s like this –

    Then it’s a Junctional Rhythm.

    If the rhythm is fast – (narrow complex tachycardia without P waves)

    Then it’s an SVT. (supraventricular tachycardia)

    If the rhythm is like this –

    It’s “A-Fib” or atrial fibrillation.

    If it’s like this-

    It’s an atrial standstill (very rare – usually caused by hyperkalaemia)

    If there’s a wide QRS complex-

    It’s an idioventricular rhythm, and if it’s fast-

    It’s ventricular tachycardia/VT.

    No P-wave? Atrial standstill, or what has been termed silent atrium, defined as the absence of electrical “and” mechanical activity.

    It means the top two chambers of the heart, are not able to start an electrical impulse, propagate that electrical impulse, or be electrically stimulated, and therefore are not moving or contracting (mechanical).

    Others suggest atrial fibrillation. Fine AF? P waves may not be easily identifiable as well in fine AF.

    Too much Potassium. Atrial standstill is relatively rare, most cases occur bc of high levels of potassium, (see hyperkalemia) in the blood. Renal failure (patient usually on dialysis) and hyperkalemia is a common presentation.

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    It means that the atria are not contracting because there is no electrical stimulus from the sinus node or from somewhere else in the muscle of the atria.

    Or, it could mean that the heart is in atrial fibrillation (completely chaotic electrical activity in the atria also resulting in the absence of atrial contraction). In place of the P wave one will just see irregular rapid small amplitude waves.

    There are a few other possibilities as well but the explanations get a little complex for those without medical training…


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    There are a few heart arrhythmias that show that feature. The primary arrhythmia that has no p wave present is premature ventricular contraction (PVCs). Atrial fibrillation has no discernable p wave present. AV nodal arrhythmias can affect p waves also. They can be not present or buried within the QRS complex.


    It means that something about your heart is unusual but doesn’t indicate what. It could be anything from “You are are young and athletic” to “You are in the early stages of having a heart attack” (which could be fatal – but not in your case because you are still here). Most commonly it is related to a virus affecting the heart (usually harmless if you rest) or high blood pressure (which needs treating).

    Anyway it means you should have other heart tests to identify any serious cause.


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    I don’t have the full EKG to review and this site is not for personal medical review, but those type of notches in this tracing are common and normal.


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    A phonogram is a sound recording, any sound recording, are you asking agout a phonocardiogram? That is the sound recording of heart murmers and other heart sound, depicted graphically, Chapter 2. Phonocardiography

    Havn’t seen this for decades, I think largely replaced by echocardiography which gives you a moving imaging of the heart.

    An electrocardiogram shows you the heart’s electrical activity depicted graphically.


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    Extremely unlikely, but, lots of people suffer a heart neurosis, nothing actually physically wrong, but lots of anxiety, panic even.


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    There’s is a huge story behind labelling the ecg waves

    The full article is given in this site


    If u r more curious you can read it

    But I would give you a brief conclusion


    Einthoven named the waves in the ECG PQRST and U. Having labeled the uncorrected waves made by the Lippmann capillary electrometer ABCD, Einthoven wanted to show how his mathematically corrected waves differed from uncorrected waves. Therefore, he had to use labels other than ABCD. He chose PQRST because he was undoubtedly familiar with Descartes’ labeling of successive points on a curve. Perhaps as an afterthought, he recognized that by choosing letters near the middle of the alphabet, he would have other letters to label waves that might be found before the P wave or after the T wave. He later discovered the U wave when he developed the string galvanometer. Why Einthoven mixed the old with the new labeling in the tracing made with the string galvanometer shown in the postage stamp created to honor him is bewildering and unexplained.

    Segers, Lequime, and Denolin named the delta wave. They chose delta because 1 side of the slurred part of the QRS complex seems to parallel 1 side of the Greek letter delta.

    Clinicians named the spike-and-dome wave caused by hypothermia the Osborn wave in honor of Osborn. More research is needed to determine the mechanisms responsible for the abnormal J deflections that appear in a diverse group of conditions.

    Fontaine discovered and named the epsilon waves. He chose the epsilon because it follows delta in the Greek alphabet and is the mathematical symbol for smallness.

    Note : This article is taken from the above mentioned site

    When the heart is suffering from the presence of blocked arteries (such as during intense exercise), or when a heart attack is occuring, changes in the heart’s electrical activity also occurs, which can be recognized on a patient’s ECG. One such change is in the T waves of the ECG, which represents contraction and recovery of the main pumping chambers of the heart. “Nonspecific” changes refers to the evidence of change in the T waves that is inconclusive as to whether the observed changes may accurately correspond to the presence of blockages or to an actual heart attack. Suspicion has been raised, and other tests (such as an angiogram) may be necessary for further clarification.

    The P wave on the electrocardiogram is formed by electrical discharge in the atria of the heart – normally from the sinoatrial node (SAN). This discharge leads tothe co-ordinated contraction of the heart atria, and leads to the organised contraction of the rest of the heart milliseconds later.


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