OSBORN WAVE (J Wave) IN ECG AND ITS INTERPRETATION
1. Osborn Wave (J Wave)
Dr.G.VENKATA RAMANA
MBBS DNB FAMILY MEDICINE
2. • Osborn wave (J wave)
• Positive deflection seen at the J point in precordial and
true limb leads
• Most commonly associated with hypothermia
• These changes will appear as a reciprocal, negative
deflection in aVR and V1
• The J point in the ECG is the point where the QRS
complex joins the ST segment
• It represents the approximate end of depolarization and
the beginning of repolarization as determined by the
surface ECG
• There is an overlap of around 10ms
• The J point may deviate from the baseline in early
repolarization, epicardial or endocardial ischemia or injury,
pericarditis, RBBB, LBBB, RVH, LVH or digitalis effect
3. J point in a) normal; b) J point elevation; c) with Osborn wave (J wave);
d) J point depression
Note: The letter J on the ECG defines 2 totally different and unrelated events
The J point is a point in time marking the end of the QRS and the onset of the ST
segment present on all ECGs
The J wave is a much less common, slow deflection of uncertain origin originally
described in relation to hypothermia
4. • Osborn Wave Causes
• Characteristically seen in hypothermia (typically T < 30C), but they
are not pathognomic
• Causes of non-hypothermic Osborn waves include:
• Hypercalcemia
• Acute myocardial ischemia
• Takotsubo cardiomyopathy
• Left ventricular hypertrophy due to hypertension
• Normal variant and early repolarization
• Neurological insults such as intracranial hypertension, severe head
injury and subarachnoid hemorrhage
• Severe myocarditis
• Brugada syndrome
• Le syndrome d’Haïssaguerre (idiopathic VF)
• Compared to other hypothermia-induced ECG abnormalities (e.g.
sinus bradycardia; supraventricular arrhythmias, QT prolongation
and AV block), the Osborn wave is thought to be the most specific
5. Osborn Wave ECG examples
Subtle J waves in mild hypothermia [Temp: 32.5°C (90.5°F)]
The height of the J wave is roughly proportional to the degree of
hypothermia
6. •J waves in moderate hypothermia [Temp: 30°C (86°F)]
7. •J waves in moderate hypothermia. [Temp: 28°C (82.4°F)]
8. •Marked J waves in severe hypothermia [Temp: 26°C (78.8°F)]
•Note “negative” J waves seen in aVR and V1
