Abstract
In 1906, 11 years after Einthoven's first description of the P-QRS-T complex in a human electrocardiogram in 1895, 1 Einthoven W. Über die Form des menschlichen Electrocardiogramms. Pflugers Arch Gesamte Physiol. 1895; 60: 101-123 Crossref Scopus (77) Google Scholar he reported the existence of a wave after the T-wave, accordingly named U-wave, in a patient with “degenerative myocardial disease.” 2 Einthoven W. Le telecardiogramme. Arch Int Physiol. 1906; 4: 132-164 Google Scholar In the following years, Einthoven and Lewis noted the existence of a U-wave in the majority of their tracings. 3 Einthoven W. The different forms of the human electrocardiogram and their signification. Lancet. 1912; 179: 853-861 Abstract Scopus (104) Google Scholar , 4 Lewis T. Gilder M.D.D. The human electrocardiogram: a preliminary investigation of young male adults, to form a basis for pathological study. Philos Trans R Soc Lond B Biol Sci. 1912; 202: 351-376 Crossref Google Scholar Einthoven stated that the U-wave is normally of low amplitude but may reach considerable height in pathological cases. 3 Einthoven W. The different forms of the human electrocardiogram and their signification. Lancet. 1912; 179: 853-861 Abstract Scopus (104) Google Scholar Lewis related the U-wave to the diastolic phase of the cardiac cycle because it appeared directly after the second heart sound. 4 Lewis T. Gilder M.D.D. The human electrocardiogram: a preliminary investigation of young male adults, to form a basis for pathological study. Philos Trans R Soc Lond B Biol Sci. 1912; 202: 351-376 Crossref Google Scholar At present, the clinical significance of the U-wave is not much valued. It often escapes observation, and its genesis has been debated over the last century. Yet, interference of a U-wave with measurement of the QT-interval may lead to iatrogenic harm. 5 Lepeschkin E. The U wave of the electrocardiogram. Arch Intern Med. 1955; 96: 600-617 Crossref Scopus (21) Google Scholar , 6 Surawicz B. U wave: facts, hypotheses, misconceptions, and misnomers. J Cardiovasc Electrophysiol. 1998; 9: 1117-1128 Crossref PubMed Scopus (93) Google Scholar , 7 Taggart N.W. Haglund C.M. Tester D.J. et al. Diagnostic miscues in congenital long-QT syndrome. Circulation. 2007; 115: 2613-2620 Crossref PubMed Scopus (189) Google Scholar Further, a negative U-wave where this deflection is usually positive is almost always associated with cardiac pathology. 5 Lepeschkin E. The U wave of the electrocardiogram. Arch Intern Med. 1955; 96: 600-617 Crossref Scopus (21) Google Scholar , 6 Surawicz B. U wave: facts, hypotheses, misconceptions, and misnomers. J Cardiovasc Electrophysiol. 1998; 9: 1117-1128 Crossref PubMed Scopus (93) Google Scholar The mere fact that the U-wave genesis remains an enigma after its first description over 100 years ago justifies its further investigation. 6 Surawicz B. U wave: facts, hypotheses, misconceptions, and misnomers. J Cardiovasc Electrophysiol. 1998; 9: 1117-1128 Crossref PubMed Scopus (93) Google Scholar
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