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P-wave Axis Deviation Index: Explanation and Clinical Context The P-wave axis is calculated using the frontal plane ECG leads I and aVF to estimate atrial depolarization direction. A normal P-wave axis ranges from 30° to 75° in adults. Values outside this range indicate potential right or left atrial enlargement, atrial conduction abnormalities, or underlying structural heart disease.
Abnormal P-wave axis has been associated with increased risk of atrial arrhythmias, including atrial fibrillation, and may provide incremental prognostic information in cardiovascular risk assessment.
Evidence & references1 primary source mapped
- Source 1
Kawasaki T, et al. Electrocardiographic P-wave axis and prediction of atrial fibrillation: The Hisayama Study. Heart Rhythm. 2018;15(12):1813-1820. doi:10.1016/j.hrthm.2018.07.013
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