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The P wave is the first wave in an ECG complex, and it results from the atria depolarizing. It may not be present in arrhythmias where the atria do not necessarily depolarize, such as junctional or ventricular escape rhythms, and at times when the atria are depolarizing abnormally this will be reflected in the P wave's replacement by abnormal waves, such as the low-amplitude "squiggle" seen in atrial fibrillation, or the "sawtooth" pattern seen in atrial flutter.

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