Heart Rhythm Community
What ECG rhythm is this
About This Community:

Join others experiencing Heart Rhythm issues. Ask a question, join a conversation, share experiences: symptoms, management, and treatment.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

What ECG rhythm is this

12 lead ecg shows 2 p waves within a PR  interval of .24 seconds. The p waves are different shapes--the first p wave is normal shape,  the second p wave is smaller and a little more peaked. But the p waves are very distinct. The patient does not have an av block or atrial flutter or atrial tach. The pattern is consistent through the 12 lead. The patient has no known cardiac history.
5 Comments Post a Comment
Blank
1124887 tn?1313758491
Hello.

I've never heard about such a rhythm, unfortunately (but I'm not a healthcare professional).

At PR .24 seconds, the patient has an AV block (1st degree). He could suffer an intra-atrial conduction disturbance or an enlarged left atrium, but if so, the P wave would usually be markedly negative in V1. In other words a biphasic P wave.

Do the P and the P' wave have similar axis? If so, maybe you are seeing a biphasic P wave (as mentioned above). I strongly doubt the case is an ectopic P wave (atrial bigeminy) so close to the normal P wave. As mentioned, I have never heard about depolarizations happening before the QRS complex, and if it happened, it would very likely trigger atrial fibrillation.

Sorry I can't provide a better answer. Maybe you should ask an MD.

Blank
1124887 tn?1313758491
Sorry, I meant to say "the terminal part of the P wave would be markedly negative in V1".
Blank
1398166 tn?1358874123
There are no Doctors here. Maybe PhD's in French History or Physics. My daughter is as qualified as anybody here. She knows everything and likes Justin Timberlake.

I advise you ask your Doc.
Blank
995271 tn?1463927859
I think this may have been someone studying for a certification exam.  I see these academic-style questions pop up on here once in a while.

The is written just like a cert or board exam question stem.  

"The patient has no known cardiac history." tells me this isn't about the poster.

I'm troubled by it when I see it because if this is how the person figures things out (basically cheating) they probably have poor diagnostic skills.  I'm sorry to the original poster if I'm wrong, please do correct me if that's the case.
Blank
Avatar f tn
Is there a picture of the strip or 12-lead?  My first thought would be some sort of artifact.  It's hard to answer though without actually seeing it.  Are you sure that both are p waves and not the t wave and p wave?  Another thought would be regular nonconducted PACs.
Blank
Post a Comment
To
Top Arrhythmias Answerers
612551 tn?1450025775
Blank
Jerry_NJ
NJ
1807132 tn?1318747197
Blank
MichelleP_3811
Chicago, IL
995271 tn?1463927859
Blank
itdood
PA
12492606 tn?1459877633
Blank
researcher09
CA
Avatar f tn
Blank
CFS56
1423357 tn?1414258965
Blank
tom_h
Central, MA
Recent Activity
Avatar f tn
Blank
slgsliving Sharon Comment
2 hrs ago
17568 tn?1424977159
Blank
Cindy is... Comment
Jun 29
1236893 tn?1408490528
Blank
Dr. Peter Glidden ND
Jun 29 by gymdandee
Heart Rhythm Community Resources
RSS Expert Activity
233488 tn?1310696703
Blank
Marathon Running Done Over Many Yea...
05/15 by John C Hagan III, MD, FACS, FAAOBlank
233488 tn?1310696703
Blank
New Article on Multifocal IOL vs &q...
05/15 by John C Hagan III, MD, FACS, FAAOBlank
748543 tn?1463449675
Blank
TMJ/TMJ The Connection Between Teet...
01/15 by Hamidreza Nassery , DMD, FICOI, FAGD, FICCMOBlank
Top Arrhythmias Answerers
612551 tn?1450025775
Blank
Jerry_NJ
NJ
1807132 tn?1318747197
Blank
MichelleP_3811
Chicago, IL
995271 tn?1463927859
Blank
itdood
PA
12492606 tn?1459877633
Blank
researcher09
CA
Avatar f tn
Blank
CFS56
1423357 tn?1414258965
Blank
tom_h
Central, MA