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P wave: Discussion

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* Pos: I, II, V4, V5, V6, AVF; Neg: AVR * Best Seen: II and V1; * Duration: PR: 0.12 - 0.20 msec; 
- < 0.12 msec: consider: 
- > 0.20 msec: consider: 
- Normal varient (large person); 
- Problem AV node: ? AV block, drug effect; 
- Intra Atrial Cond. defect: Hyper K, Large Atrium 
- Bifasicular Block; * Notching/Bipolar pattern: Atrial hypertrophy * Inverted P wave: 
- II, III, aVF: implies Ectopic Low Atrial Rhythm /Junctional; 
- I (and V5,6) or < 80^/ > 0^: 
- Arm Lead Reversal, Dextrocardia, Ectopic Left Atrial Rhythm