Absent P waves?

P-waves

by AgentX86 - 2021-03-07 22:21:35

Missing p-waves are a symptom of Aflutter.  I thought there would be none but perhaps you're mistaking the flutter for the 'p-waves'?  Can you see a flutter sawtooth on lead-3 ?

Not sure about sawtooth...

by asully - 2021-03-07 22:27:21

Maybe in the non-enhanced versions.  If it's flutter or fib it's very fine.  Is there a way I can email u the PDFs? You can pm me.

Could mean more than Fibrillation or Flutter

by Gemita - 2021-03-08 03:18:59

https://medschool.co/tests/ecg-basics/the-p-wave

Have a read of the above might help (unless you have already seen).  

Also check for electrolyte imbalances and thyroid for worsening palpitations Asully.  I recall my husband had some absent P waves on an ECG report when he was suffering from a potassium imbalance.  My husband's cardiologist at the time didn't seem too concerned but I remember he did mention that many conditions can affect P waves, not just tachycardias like Flutter and Fibrillation.  He mentioned P wave changes would expect to be found in patients with ischaemic heart disease and left ventricular failure.  

Why don't you send a copy of your 6L print to your EP for a full analysis?  It could be that your CRT pacing needs some fine tuning?  You have the evidence so I would use it Asully.

Gemita

by asully - 2021-03-08 13:55:38

Yeah I plan on showing what I can to my EP.  I am not sure how much time the EPs in the UK will spend with you, but my experience is I get about ten minutes with them, and they will only look at one or two readings.  I don't think it's that they don't care, they just are over scheduled.  So I try and pick out the readings I think are most relevant, obviously showing them 5 readings of a paced sinus rhythm is a waste of time, so I like to make sure I am not wasting anyone's time.

P Waves

by kama51 - 2021-03-08 23:19:34

i was having a hernia op last week when my p waves were stopping for 6 seconds which meant the ventricle was not pumping blood and oxygen.Later that day i had a ppm fitted.I was told the length of the failure was not good and is called a ventricular standstill.Failure of the ventricle to pump the blood for a period of time leads to heart failure.I was lucky it happened during an operation and they caught in on the monitor.

P-Wave

by AgentX86 - 2021-03-08 23:57:28

The P-wave is atrial contraction.  This is followed by the QRS complex, the large pulse on the EKG. This is the electrical signal from the ventricles contracting.

A P-wave is missing when in Aflutter flutter because the re-entrant circuit is provding the stimulus for the atrium and it's so small it can't be seen on lead-1.  Lead-3 will show a sawtooth pattern which is the re-entrant circuit causing the atria to flutter.  The flutter is normally 200 to 3000bpm.  The direction of the sawtooth tells whether the flutter circuit is in the right (typical Aflutter) or the left (atypical). 

If everything else is working right, the AV node filters this high rate signal so that it doesn't reach the ventricles avoiding V-tach.  If the AV node isn't working right there is a condition called flutter with a 1:1 conduction, which is bad.  Very bad.

So, as long as there is a QRS, the ventrical should be pumping.  The p-wave isn't necessary as long as there is  QRS.

NO P WAves

by PacedNRunning - 2021-03-14 04:34:59

Were the P waves when you were at your LRL? Second when you are atrially paced, the P waves are flat depending on where the lead sits in the heart on these one lead devices.  When I'm at my LRL of 50, My P waves are flat.  Your normal looking P waves are your own instrinic no paced P waves.