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The U-wave: A remaining enigma of the electrocardiogram
Moa Kihlgren1, Christina Almqvist1, Fereydoun Amankhani1
1Cardiovascular Safety Center of Excellence and Safety Knowledge Groups, Global Patient Safety, Oncology R&D, AstraZeneca Gothenburg, Sweden.
Journal of Electrocardiology
|March 12, 2023
Summary
The origin of the U-wave on electrocardiograms is still debated, but abnormal U-waves can indicate heart disease and predict cardiovascular prognosis. Incorporating U-wave analysis into ECG assessments may improve patient outcomes.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- The electrophysiological origin of the U-wave on an electrocardiogram (ECG) is not well understood and remains a subject of debate.
- Currently, the U-wave is infrequently utilized for diagnostic purposes in clinical practice.
Purpose of the Study:
- To review recent findings concerning the U-wave.
- To present proposed theories on the U-wave's origin.
- To explore its potential pathophysiological and prognostic implications based on presence, polarity, and morphology.
Main Methods:
- A comprehensive literature search was conducted using the Embase database.
- Publications related to the electrocardiogram U-wave were retrieved and reviewed.
Main Results:
- Major theories discussed include late depolarization, delayed/prolonged repolarization, electro-mechanical stretch, and intrinsic potential differences.
- Abnormal U-waves correlate with various cardiac conditions like coronary artery disease, ventricular hypertrophy, and cardiomyopathy.
- Negative U-waves are highly specific for heart disease and associated with increased mortality risk in men.
Conclusions:
- The precise origin of the U-wave remains undetermined.
- U-wave analysis can aid in diagnosing cardiac disorders and assessing cardiovascular prognosis.
- Integrating U-wave characteristics into routine ECG assessments could prove beneficial.
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