P Wave

I just got out of the hospital after spending 4 days there. Whew, I'm sure glad to be home!

I have a "technical question" I guess you could call it.

I was told that there were no P waves on my EKG at times. What does this mean? I have no sinus node after an ablation back in November. Sometimes there is a P wave present, and other times there is not.

My pacemaker has been set to the bare necessities for a couple of days and I have been taken off all cardiac meds. This means that my heart rate is staying at 70 during any activity, which is pretty uncomfortable. I am also having bursts of tachy at rest.

They have made these changes in hopes of seeing what my own heart can do without the pacemaker...which isn't much, and to rule out the pacemaker being the cause of my tachy.

I saw my EP's partner while in the hospital because my EP was on vacation. So, I'm hoping that between the two of them, they can get my situation sorted out and figure out what to do with me. :)

Thanks,
Amanda

6 Comments

Thanks Guys!

by scadnama - 2009-03-31 02:03:37

Thanks for your responses!!!

I'm not really concerned, but more so curious as to what may be causing this.

The missing P wave was captured several times by different monitors...at both hospitals, and during transport.

A fib was mentioned as the culprit, but I was never given a firm diagnosis.

Hopefully I can find out tomorrow when I see my doctor!

Thanks again,
Amanda

P wave

by BillMFl - 2009-03-31 04:03:10

Is the first relatively small wave on the ECG that indicates your sinus node/atrium have initiated your electrical activity (atrial depolarization) The P wave is followed by the QRS complex, which includes the high spike indicating your ventricle has responded (Ventricular depolarization). The QRS is followed by the T wave(ventricular repolarization). With a normal sinus rhythm, these three waves are the the three that repeat over and over again in a regular pattern. With Sick Sinus Syndrome, the P wave can be weak, irratic or totally absent. A cardiologist can often detect the origin of electrical problems by looking at the shape and time intervals of these waves. There are lots of odd looking waves caused by a wide variety of problems, including infarction. But the P wave is the first electrical activity that paces the normal heart.. Please understand that this is a simplification. Entire text books are written about this subject.

P waves

by Pookie - 2009-03-31 04:03:30

Hi.

In my case, my P wave is upside down.

All I know, in my case, is that my SA node is not where my heart starts its electrical beat. I am assuming that is why the P wave is inverted.

I am finally going to get to meet with an EP (as promised at yesterday's cardiologist appointment) so I'm thrilled as I've had this darn pacemaker for 4+ years now and still have oodles of questions, one being Junctional Rhythm which I stumbled across while reading my medical file.

There is SO much to learn about our hearts that sometimes it feels a bit overwhelming, don't you think? But I have found that the folks here are way better in explaining anything then the doctors as in my case everything they say goes right over my head.

Sharing information has been such a valuable tool for me and I certainly appreciate everyone's input and support.

Good luck Amanda & keep us posted.

Pookie

hey

by tcrabtree85 - 2009-03-31 06:03:06

Hey girl, hope you were able to get some answers. I found out today that i'm in a-fib. It seems to never end. hmmm. I also thought my pmt were good now with the changes but not exactly I have had 6 episodes recorded. Crazy. I will call and check on you soon girl.

Much love and get that rest.

Tammy

Pookie

by BillMFl - 2009-03-31 10:03:26

An inverted P wave is often due to junctional rhythm. The P is a retrograde signal initiated by the junction that flows back to the atrium and shows up as a negative wave on the ECG. Your wave dips down instead of rising up in a smooth bump.

P Waves

by SMITTY - 2009-03-31 12:03:34

Hi Amanda,

Welcome home, I can only imagine how glad you must be to get home. That is some wild ride you have been having, but hopefully they are about to get your problem fully identified and can arrive at a solution for you.

If you had an ablation that could make you pacemaker dependent. If your sinus node has failed because of the ablation and is no longer producing P waves this may well be a moot issue, and since your doctor didn't keep you in the hospital I think this would mean you don't need to be unduly concerned.

It may mean, however, a possible adjustment in how the pacemaker should be set for optimum operation, which I think you indicated may be in your future. If there was a cause for concern in this regard I think the cardiologist would have kept you to the hospital longer rather than let you come home.

If you want a real good explanation of the significance of the P wave go to Google and put in "ECG P Waves." The first article ECG Introduction speaks at length on what a doctor can see about our heart from an ECG tracing. The article is by Richard E. Klabunde, Ph.D. and talks about all the specifics of an ECG. The first paragraph is a general description and the second paragraph deals specifically with the P wave. Other parts of the ECG follow thereafter.

I wish you the best,

Smitty

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