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Steps should be taken to define P Wave morphology

  1. General contour
  2. P Wave Duration
  3. positive and negetive Amplitude
  4. Axis in the frontal and transverse planes.

General Contour

  • It generally Smooth and entirely positive or negetive or monophesic. except V1 and V2

P wave Duration

  • Normally < 0.12 second
  • It's indicate the relative time of activation in the right and left atria.

Positive and Negetive Amplitudes

  • Normally no more than 0.2 mv in frontal plane leads.
  • normally no more than 0.1 mv in transverse plane leads.

Axis in the frontal and transvers planes.

  • P Wave Normally appers entirely upright and left ward and inferiorly oriented leads such as I, II, aVF and V4 To V6.

  • P wave axis are between 0 and +75 degree.

There are basically Four type of P wave observed

  1. Normal
  2. RAE (Right Atrial Enlargments)
  3. LAE (Left Atrial Enlargnments)
  4. RAE + LAE (Both Enlargments)

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