An abnormal U wave !

U wave, one of the most forgotten wave in ecg. It’s often submerged beneath pqrst wave analysis even by experts.

Let’s have a glance on this small hump.Given below as points….

 The most common theories for the origin are:

  • Delayed repolarization of purkinje fibres
  • Prolonged re-polarisation of mid-myocardial M-cells
  • After-potentials resulting from mechanical forces in the ventricular wall
  • The repolarization of the papillary muscles

  • U wave if present is negative in avR and rarely in lead 3 and avf
  • It’s rare to find a u wave in lead 1,avL and avR
  • U wave amplitude increase with most of the inotropic agents and bradycardia
  • Inversion of u wave in exercise testing is a good idea to diagnose LAD stenosis
  • Prominent U waves are seen in hypokalemia and hypercalcemia
  • U wave alternans seen in Lvf and Romano ward syndrome.

Now a qn…how to make out T- U fusion versus a notched T wave?This is not uncommon.

See the comments section for the answer
That’s all folks for the day ..

Good day!

One thought on “An abnormal U wave !

  1. Answer: use leads where u is absent usually like lead 1,avl,avr.Another clue is notch of T-U fusion is located at a lower level <0.2mV while opposite is true often the case of a T wave notch


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