Inverted P wave

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ordinarily, an impulse traveling from a point high in the atrium to the ventricle is right side up on the electrocardiographic tracing, but if this pacemaker impulse originates in lower part of the atrium, the orientation of the electrical vector may cause it to appear upside down or to be an "inverted P-wave".