Inverted P waves in inferior leads – Cardiology MCQ
Inverted P waves in inferior leads may be seen in all except:
a) Junctional rhythm
b) Left atrial rhythm
c) Coronary sinus rhythm
d) Accelerated idioventricular rhythm
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Johnson Francis
Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal
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Dear Prof, Forgive my ignorance…why specifically the inferior leads? Thanks..Have always enjoyed your postings, they are more than pearls
Dear Prof, Forgive my ignorance…why specifically the inferior leads? Thanks..Have always enjoyed your postings, they are more than pearls
@NKS: Inferior leads face the lower part of the heart. Normal P wave activation spreads from the sinus node downwards so that the activation is towards the inferior leads and recorded as positive. When the activation starts in the lower part of the atria and spreads upwards as in junctional rhythm and low atrial rhythm, it is away from the inferior leads and recorded as negative. Basic principle of electrocardiography is that any activation spreading towards the recording electrode is seen as positive and that spreading away from the electrode is recorded as negative or inverted.
…so Low atrial Rhythm also means Right Atrial Rhythm, is that correct? Thanks
Usually so. In case of left atrial rhythm, it is usually specified as left atrial rhythm.