Osborn Wave (J Wave)

Definition

• The Osborn wave (J wave) is a positive deflection at the J point (negative in aVR and V1)
• It is usually most prominent in the precordial leads

Causes

• Characteristically seen in hypothermia (typically T<30C), but they are not pathognomonic.
• J waves may be seen in a number of other conditions:
  • Normal variant
  • Hypercalcaemia
  • Medications
  • Neurological insults such as intracranial hypertension, severe head injury and subarachnoid haemorrhage
  • Le syndrome d’Haïssaguerre (idiopathic VF)

Typical J Waves

Typical J Waves

Hypothermia

The height of the J wave is roughly proportional to the degree of hypothermia:

Subtle J waves in mild hypothermia (temp 32.5°C)

J waves in mild hypothermia

J waves in moderate hypothermia (temp 30°C)

J waves in moderate hypothermia

Marked J waves in severe hypothermia (temp < 27°C)

J waves in severe hypothermia

Further Reading

• ECG BASICS – Waves, Intervals, Segments and Clinical Interpretation
• ECG CLINICAL CASES – Your favourite ECG’s placed in clinical context with a challenging Q&A approach
• ECG and Cardiology Eponymous Syndromes – Cheats guide to eponymous emancipation
• ECG Reference Sites on the WEB – the best of the rest

Author Credits

• Mike Cadogan, Ed Burns

References

• Haïssaguerre M, et al. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008 May 8;358(19):2016-23. PMID: 18463377.
• Otero J, Lenihan DJ. The “normothermic” Osborn wave induced by severe hypercalcemia. Tex Heart Inst J. 2000;27(3):316-7. PMID: 11093425
• Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice (6th edition), Saunders 2008.
• Wagner, GS. Marriott’s Practical Electrocardiography (11th edition), Lippincott Williams & Wilkins 2007.