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. 2019 May 3;6:53. doi: 10.3389/fcvm.2019.00053

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Copyright © 2019 Chen and Soliman.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Representative ECG tracings of abnormal P-wave indices. A through (D), Prolonged P-wave duration (A), abnormal P-wave axis (B), abnormal P-wave terminal force in V1 (C), and advanced interatrial block (D). (A) The maximal P-wave duration is seen in lead II (136 ms). (B) The gray area on the hexaxial reference system (lead I 0°, lead II 60°, aVF 90°, aVR −150°, aVL −30°) represents normal P-wave axis (0–75°). The P-wave axis on B is −27°. (C) The P-wave terminal force is −9,632 μV*ms (amplitude −112 μV, duration 86 ms). (D) The maximal P-wave duration is seen in lead III (136 ms). Biphasic P-waves can be seen in III and aVF. This figure has been republished from Maheshwari et al. (30). Chen and Soliman are allowed to republish this figure, per American Heart Association Journal Policy.