{"id":20922,"date":"2015-12-06T10:31:24","date_gmt":"2015-12-06T05:01:24","guid":{"rendered":"https:\/\/cardiophile.org\/?p=20922"},"modified":"2015-12-06T10:31:24","modified_gmt":"2015-12-06T05:01:24","slug":"u-wave-on-ecg","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/u-wave-on-ecg\/","title":{"rendered":"U wave on ECG"},"content":{"rendered":"<h2><span style=\"color: #008000;\">U wave on ECG<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/egVD_da5zus\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<p id=\"postcontent\">U wave on ECG occurs after the T wave and is usually seen in the mid precordial leads. In hypokalemia, T wave becomes flattened and U wave becomes prominent (or apparently so because of near absence of T waves). Important conditions associated with U waves are systemic hypertension, aortic and mitral regurgitation and coronary artery disease [1].<\/p>\n<p><span style=\"color: #0000ff;\"><b>Theories about genesis of U waves<\/b><\/span><\/p>\n<p>One theory about the genesis of U wave is that it is due to repolarization of the Purkinje fibres. Another possibility is that it is due to after potentials caused by mechanical forces in the ventricular wall. A third hypothesis suggests that it is due to prolonged repolarization of the mid myocardial M cells [2]. Yet another hypothesis is the delayed repolarization of papillary muscles [3]. None of these theories have been widely accepted.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Importance of negative U wave<\/strong><\/span><\/p>\n<p>An inverted U wave usually has the same significance as an inverted T wave. A negative U wave is considered to be highly specific for heart disease and is associated with other abnormal findings on ECG in 90% of cases [1].<\/p>\n<p>A discordant U wave inversion (with upright T wave) is also thought to represent myocardial ischemia.<\/p>\n<p>An interesting case of U wave due to compression of the right ventricle by a reconstructed stomach tube after surgery for esophageal cancer has been reported [4].<\/p>\n<p>Persistent giant U wave inversion was noted in a case after anoxic brain injury [5].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Exercise induced U wave inversion<\/strong><\/span><\/p>\n<p>Exercise induced U wave inversion in anterior leads has been associated with stenosis of proximal left anterior descending coronary artery in multiple case reports [6,7].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>U wave alternans<\/strong><\/span><\/p>\n<p>U wave alternans along with pulsus alternans has been described in left ventricular failure [8].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li><span style=\"line-height: 1.5;\">Kishida H, Cole JS, Surawicz B. <a href=\"_wp_link_placeholder\" data-wplink-edit=\"true\">Negative U wave: a highly specific but poorly understood sign of heart disease<\/a>.&nbsp;Am J Cardiol. 1982 Jun;49(8):2030-6.<br \/>\n<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Ritsema van Eck HJ, Kors JA, van Herpen G. The elusive U wave: a simple explanation of its genesis. J Electrocardiol. 2003;36 Suppl:133-7.<br \/>\n<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">P\u00e9rez Riera AR, Ferreira C, Filho CF, Ferreira M, Meneghini A, Uchida AH, Schapachnik E, Dubner S, Zhang L. The enigmatic sixth wave of the electrocardiogram: the U wave.&nbsp;Cardiol J. 2008;15(5):408-21.<br \/>\n<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Yamagata K, Uno K, Mori K, Seto Y. Unusual U wave induced by reconstructed retrosternal esophagus.&nbsp;Clin Case Rep. 2015 Nov;3(11):949-951.<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Peters MN, Katz MJ, Howell LA, Moscona JC, Turnage TA, Delafontaine P. Persistent giant U wave inversion with anoxic brain injury.&nbsp;Proc (Bayl Univ Med Cent). 2013 Apr;26(2):177-8.<br \/>\n<\/span><\/li>\n<li>Costantini M, Capone S, Tondo A, Oreto G.&nbsp;Is exercise-induced U-wave inversion predictive of proximal left anterior descending coronary artery disease?&nbsp;J Electrocardiol. 2008 Mar-Apr;41(2):99-101.<\/li>\n<li><span style=\"line-height: 1.5;\">Raveendran S, Hadfield R, Petkar S, Malik N. Significance of exercise induced U wave inversion as a marker for coronary artery disease.&nbsp;BMJ Case Rep. 2012 Feb 10;2012. pii: bcr0420114132.<br \/>\n<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Eyer KM. U wave alternans: an electrocardiographic sign of left ventricular failure.&nbsp;Am Heart J. 1974 Jan;87(1):41-5.<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>U wave on ECG U wave on ECG occurs after the T wave and is usually seen in the mid precordial leads. In hypokalemia, T wave becomes flattened and U wave becomes prominent (or apparently so because of near absence of T waves). Important conditions associated with U waves are systemic hypertension, aortic and mitral [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":31995,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[1163,1423,1575,4085,4086],"class_list":["post-20922","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","tag-discordant-u-wave-inversion","tag-exercise-induced-u-wave-inversion","tag-genesis-of-u-waves","tag-u-wave-alternans","tag-u-wave-inversion"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>U wave on ECG occurs after the T wave in the mid precordial leads.<\/title>\n<meta name=\"description\" content=\"U wave on ECG occurs after the T wave and is usually seen in the mid precordial leads. In hypokalemia, T wave becomes flattened and U wave becomes prominent (or apparently so because of near absence of T waves).\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/u-wave-on-ecg\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"U wave on ECG occurs after the T wave in the mid precordial leads.\" \/>\n<meta property=\"og:description\" content=\"U wave on ECG occurs after the T wave and is usually seen in the mid precordial leads. In hypokalemia, T wave becomes flattened and U wave becomes prominent (or apparently so because of near absence of T waves).\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/u-wave-on-ecg\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-12-06T05:01:24+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"U wave on ECG\",\"datePublished\":\"2015-12-06T05:01:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/\"},\"wordCount\":496,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"discordant U wave inversion\",\"Exercise induced U wave inversion\",\"genesis of U waves\",\"U wave alternans\",\"U wave inversion\"],\"articleSection\":[\"ECG \\\/ Electrophysiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/\",\"name\":\"U wave on ECG occurs after the T wave in the mid precordial leads.\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/u-wave-on-ecg\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2015-12-06T05:01:24+00:00\",\"description\":\"U wave on ECG occurs after the T wave and is usually seen in the mid precordial leads. 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