EKG P Wave Fading Away

On my regular Cardiologist appointment every 4 months I routinely get a 12 lead EKG. Last Monday was my most recent and my Cardiologist said he could no longer detect the P wave in my EKG even after moving that lead around several times during the process.

He also said that in my previous EKG he noticed that the P wave had been diminishing. His advice to me was to get the basic Kardia and send him EKG's "sometimes" at different activity levels, etc., which I have done several times, all showing NSR. Next regular appointment is in May.

Looking on the Internet I see that lower P waves are frequently precursors for Afib or other Atrial issues. I had a Natalie ablation for Vagal Afib at Marin General some 12 years ago and have been in NSR ever since.

I'm hoping the assembled knowledge on this Board will lead me to more knowledge about how best to handle this new issue. I'm now 82 y/o and see that they sometimes are now doing ablations on people over 80 who, like me, are in otherwise good health.

Any suggestions and/or advice?

Gordon

Diminished P waves are common following an ablation and don't have any prognostic value at all. They're just a reflection of the fact that your atria have ablation lesions that interrupt the propagation of electrical impulses, and those impulses are what the ECG is recording. After multiple ablations, the last one by Natale in 2017, I have very small P waves that are barely detectable.

It's absolutely nothing to worry about at all and doesn't signal impending afib or anything else.

Honestly, if you had an ablation 12 years ago and have been in NSR ever since, I don't think you need to buy a Kardia or do anything. In fact, unless you've got other issues going on I don't know why you're seeing a cardiologist every four months.

Thanks, Carey, but I'm not sure I understand.

I had detectable P waves since my ablation up until the most recent two EKG's so the Cardiologist must wonder if something's going on in my Atria in recent months that wasn't before.

The Cardiologist also serves as an Internist for health issues other than heart that may affect my heart; i.e., gout & osteoarthritis, GERD, prostate cancer issues, et. al. I completed Cyberknife radiation for prostate cancer in May with resulting urinary issues but am wondering if that could have affected my P wave reading levels, too.

Over the years we've had a lot of posts here about gout and GERD affecting Afib.

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The Cardiologist also serves as an Internist for health issues other than heart that may affect my heart; i.e., gout ...

In this just released podcast nephrologist and researcher, Rick Johnson MD gives among other things a master class in uric acid, also fructose. Nothing in particular to do with afib.

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I had detectable P waves since my ablation up until the most recent two EKG's so the Cardiologist must wonder if something's going on in my Atria in recent months that wasn't before.

Oh, okay, I see. Have you had a routine physical lately that included the usual blood work? I don't think it's anything to worry about afib-wise, but I think you'd want to make sure your kidney function is normal and your electrolytes are all where they should be.

Annual physical with blood work scheduled for next month.

Will now move on from this topic.

Thanks again.