For biphasic P waves, both positive and negative ... given the diverse cascade of events that lead to unstable ventricular tachyarrhythmias.” 1 How and when to best use anticoagulation therapy ...
The morphology of the P wave will not be similar to the sinus P wave, which is normally upright in lead II and biphasic in lead V1. Often, the P wave is inverted in lead II, if it can be seen at all.
A sinus morphology is an upright P wave in lead II and biphasic (up and down) P wave in lead V1. The first ECG strip below shows a P wave with sinus morphology, thus normal sinus rhythm.
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