A collision between a proton and a heavy nucleus at ultrarelativistic energy creates particles whose rapidity distribution is asymmetric, with more particles emitted in the direction of the nucleus than in the direction of the proton. This asymmetry becomes more pronounced as the centrality estimator, defined from the energy deposited in a calorimeter, increases. We argue that for high-multiplicity collisions, the variation of the impact parameter plays a negligible role, and that the fluctuations of the multiplicity and of the centrality estimator are dominated by quantum fluctuations, whose probability distribution can be well approximated by a correlated gamma distribution. We show that this simple model reproduces existing data, and we make quantitative predictions for collisions in the 0−0.1% and 0−0.01% centrality windows. We argue that by repeating the same analysis with a different centrality estimator, one can obtain direct information about the rapidity decorrelation in particle production.