What do they do for an inverted P wave?

As a medical professional with expertise in cardiology, I can provide insight into what is done for an inverted P wave on an ECG. When an inverted P wave is observed, it typically indicates that the electrical impulse initiating the heartbeat is not originating from the sinus node (the natural pacemaker of the heart) but rather from a different location, such as the atrioventricular (AV) junction or even below it. This can be associated with various conditions, including but not limited to: 1. Junctional tachycardia: A regular, narrow-complex tachycardia originating from the AV junction. 2. Wolff-Parkinson-White (WPW) syndrome: A condition where an extra electrical pathway exists that can cause a rapid heart rate. 3. Atrial inversion: A rare condition where the atria are inverted in position, leading to an inverted P wave. The management of an inverted P wave depends on the underlying cause and the patient's symptoms. It may include: - Electrophysiology study: To determine the exact location and mechanism of the abnormal electrical activity. - Medication: To control the heart rate or correct the underlying rhythm disturbance. - Ablation therapy: A procedure to destroy the abnormal heart tissue causing the abnormal rhythm. - Pacemaker implantation: In some cases, a pacemaker may be necessary to regulate the heart's rhythm. It's important to note that an inverted P wave alone is not necessarily a medical emergency, but it is a sign that requires further investigation to understand the heart's electrical activity fully.

Rationale: Nonparoxysmal (gradual-onset) junctional tachycardia is a supraventricular rhythm with narrow QRS complexes and a regular rate, usually between 60�C140 bpm. The distinguishing feature of this ECG is retrograde conduction of the atrium causing an inverted P wave, best observed in lead II.