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46 Possible Causes for Inverted P Wave, Prolonged PR Interval

  • Patent Foramen Ovale

    Individuals with atrial septal defects may have a prolonged PR interval (a first degree heart block).[marmur.com] The prolongation of the PR interval is probably due to the enlargement of the atria that is common in ASDs and the increased distance due to the defect itself.[marmur.com]

  • Cardiomyopathy

    There are some signs of left atrial enlargement — leftward deviation of the P wave axis (positive P waves in I and aVL, inverted in III and aVF) and prolongation of the terminal[lifeinthefastlane.com] […] portion of the P wave in V1.[lifeinthefastlane.com] […] an interventricular conduction delay mimicking LBBB — however, this is not LBBB as the morphology is not typical and there are small Q waves in V5-6 ( the presence of Q waves[lifeinthefastlane.com]

  • Premature Atrial Contractions

    wave is abnormal Premature (earlier than expected) Morphology different than normal P wave Inverted P wave suggests atrial source near AV junction Nearly normal P waves suggest[fprmed.com] However, PR variation and prolonged PR interval were not associated with all-cause mortality (P   0.465 and 0.774, respectively).PR interval variation and prolonged PR interval[ncbi.nlm.nih.gov] PACS arising close to the AV node (“low atrial” ectopics) activate the atria retrogradely, producing an inverted P wave with a relatively short PR interval 120 ms (PR interval[lifeinthefastlane.com]

  • Atrial Bigeminy

    P wave with a PRI 120ms.[app.figure1.com] The rarer and more ominous Mobitz II second degree AV block (which frequently progresses to complete heart block) features normal or slightly prolonged PR intervals until[journals.lww.com] […] of the PR interval; atrial bigeminism.[pacingdefibrillation.com]

  • Ostium Primum Atrial Septal Defect

    Mild right ventricular hypertrophy Inverted P waves in Sinous Venosus type Right Bundle Branch Block is seen which is partial or complete 17.[slideshare.net] Individuals with atrial septal defects may have a prolonged PR interval (a first degree heart block).[marmur.com] Prolongation of the PR interval: first degree atrioventricular block ( less frequent than ostium primum ASD ).[metealpaslan.com]

  • Paroxysmal Supraventricular Tachycardia

    Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves[ncbi.nlm.nih.gov] ) this AV nodal conduction delay is manifested by a prolonged PR interval on the surface ECG.[af-ablation.org] P waves in leads II, III, aVF, V 3 -V 6 Rare: References: [1] [3] [4] Pathophysiology AVRT Do not confuse atrioventricular reentrant (or reciprocating) tachycardia ( AVRT[amboss.com]

  • Supraventricular Tachycardia

    Inverted P waves are sometimes seen after the QRS complex. These are called retrograde p waves.[acls-algorithms.com] ) this AV nodal conduction delay is manifested by a prolonged PR interval on the surface ECG.[af-ablation.org] waves may be non-identifiable, especially when the ventricular rate is high If P waves are present, they will likely be inverted in leads II, III, and aVf QRS complex duration[medictests.com]

  • Cardiac Pacemaker Insertion

    P waves are conducted to the ventricles with a prolonged PR interval (280 ms).[lifeinthefastlane.com]

  • Atrioventricular Junctional Rhythm

    Retrograde inverted P waves with short PR intervals and a heart rate of 94/minute denotes to accelerated junctional rhythm. Click here for a more detailed ECG ECG 3.[metealpaslan.com] ) this AV nodal conduction delay is manifested by a prolonged PR interval on the surface ECG.[af-ablation.org] The presence of inverted P waves indicates that the primary pacemaker has shifted to the AV node (in this case probably high in the AV node).[equimedcorp.com]

  • Atrial Tachyarrhythmia with Short PR Interval

    Diagnostic criteria include PR interval of no more than 120 ms, normal QRS complex duration, a normal or inverted P wave, and paroxysmal supraventricular tachycardia (PSVT[patient.co.uk] Note how the baseline PR interval is prolonged, and then further prolongs with each successive beat, until a QRS complex is dropped.[lifeinthefastlane.com] She was euthyroid; ECG revealed regular rhythm with inverted P waves, short PR interval, absent delta waves with normal QRS morphology ( Figure 1 ).[ncbi.nlm.nih.gov]

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