Osborn Waves: History and Significance

Maruyama, Mitsunori and Kobayashi, Yoshinori and Kodani, Eitaroh and Hirayama, Yoshiyuki and Atarashi, Hirotsugu and Katoh, Takao and Takano, Teruo (2004) Osborn Waves: History and Significance. [Journal (Paginated)]

Full text available as:

[img] HTML


The Osborn wave is a deflection with a dome or hump configuration occurring at the R-ST junction (J point) on the ECG (Fig. 1). In the historical view, different names have been used for this wave in the medical literature, such as “camel-hump sign”, “late delta wave”, “hathook junction”, “hypothermic wave”, “J point wave”, “K wave”, “H wave” and “current of injury”.1 Although there is no definite consensus about terminology of this wave, either “Osborn wave” or “J wave” are the most commonly used names for this wave in the current clinical and experimental cardiology. The Osborn wave can be generally observed in hypothermic patients,1,2,3,4 however, other conditions have been reported to cause Osborn waves, such as hypercalcemia,5 brain injury,6 subarachnoid hemorrhage,7 cardiopulmonary arrest from oversedation,8 vasospastic angina,9 or idiopathic ventricular fibrillation.10,11,12 Our knowledge about the link between the Osborn waves and cardiac arrhythmias remains sparse and the arrhythmogenic potential of the Osborn waves is not fully understood. In this paper, we present a historic review of Osborn waves and discuss their clinical significance in the various clinical settings.

Item Type:Journal (Paginated)
Keywords:Osborn wave, J wave, hypothermia, hypercalcemia, myocardial ischemia, ventricular fibrillation, history, clinical significance
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4238
Deposited By: Indian Pacing and Electrophysiology, Journal
Deposited On:17 Apr 2005
Last Modified:11 Mar 2011 08:55

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Gussak I, Bjerregaard P, Egan TM, Chaitman BR: ECG phenomenon called the J wave: history, pathophysiology, and clinical significance. J Electrocardiol 1995; 28: 49-58.

2. Thompson R, Rich J, Chmelik F, Nelson W: Evolutionary changes in the electrocardiogram of severe progressive hypothermia. J Electrocardiol 1977; 10: 67-70.

3. Okada M, Nishimura F, Yoshino H, Kimura M, Ogino T: The J wave in accidental hypothermia. J Electrocardiol 1983; 16: 23-28.

4. Eagle K: Osborn waves of hypothermia. N Engl J Med 1994; 10: 680.

5. Sridharan MR, Horan LG: Electrocardiographic J wave of hypercalcemia. Am J Cardiol 1984; 54: 672-673.

6. Hersch C: Electrocardiographic changes in head injuries. Circulation 1961; 23: 853-860.

7. De Sweit J: Changes simulating hypothermia in the electrocardiogram in subarachnoid hemorrhage. J Electrocardiol 1972; 5: 93-95.

8. Jain U, Wallis DE, Shah K, Blakeman BM, Moran JF: Electrocardiographic J waves after resusitation from cardiac arrest. Chest 1990; 98: 1294-1296.

9. Maruyama M, Atarashi H, Ino T, Kishida H: Osborn waves associated with ventricular fibrillation in a patient with vasospastic angina. J Cardiovasc Electrophysiol 2002; 13: 486-489.

10. Aizawa Y, Tamura M, Chinushi M, Naitoh N, Uchiyama H, Kusano Y, Hosono H, Shibata A: Idiopathic ventricular fibrillation and bradycardia-dependent intraventricular block. Am Heart J 1993; 126: 1473-1474.

11. Takeuchi T, Sato N, Kawamura Y, Takahashi F, Sato M, Kikuchi K, Akasaka N, Go K, Fujimoto K, Hasebe N: A case of a short-coupled variant of Torsades de Pointes with electrical storm. PACE 2003; 26: 632-636.

12. Kalla H, Yan GX, Marinchak R: Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol 2000; 11: 95-98.

13. Osborn JJ: Experimental hypothermia: Respiratory and blood pH changes in relation to cardiac function. Am J Physiol 1953; 175: 389-398.

14. Kraus F: Ueber die Wirkung des Kalziums auf den Kreislauf. Dtsch Med Wochensch 1920; 46: 201-203.

15. Kraus F, Zondek SG: Uber die Durchtrankungsspannung. Klin Wochensch I. Jahrgang 1992; 36: 1778-1779.

16. Tomaszewski W: Changements electrocardiographiques observes chez un homme mort de froid. Arch Mal Coer 1938; 31: 525.

17. Emslie-Smith D, Salden GE, Stirling GR: The significance of changes in the electrocardiogram in hypothermia. Br Heart J 1959; 21: 343-351.

18. West TC, Frederickson EL, Amory DW: Single fiber recording of the ventricular response to induced hypothermia in the anethetized dog: Correlation with multicellular parameters. Circ Res 1959; 7: 880-888.

19. Scher AM, Young AC: The pathway of ventricular depolarization in the dog. Circ Res 1956; IV: 461-469.

20. Wasserburger RH, Alt WJ, Lloyd CJ: The normal RS-T segment elevation variant. Am J Cardiol 1961; 8: 184-192

21. Litovsky SH, Antzelevitch C: Transient outward current prominent in canine ventricular epicardium but not endocardium. Circ Res 1988; 62: 116-126.

22. Yan GX, Antzelevitch C: Cellular basis for the electrocardiographic J wave. Circulation 1996; 93: 372-379.

23. Di Diego JM, Antzelevitch C: High [Ca2+]o-induced electrical heterogeneity and extrasystolic activity in isolated canine ventricular epicardium. Circulation 1994; 89: 1839-1850.

24. Lukas A, Antzelevitch C: Phase 2 reentry as a mechanism of initiation of circus movement reentry in canine epicardium exposed to simulated ischemia. Cardiovasc Res 1996; 32: 593-603.

25. Litovsky SH, Antzelevitch C: Differences in the electrophysiological response of canine ventricular subendocardium and subepicardium to acetylcholine and isoproterenol: A direct effect of acetylcholine in ventricular myocardium. Circ Res 1990; 67 615-627.

26. Fleming PR, Muir FH: Electrocardiographic changes in induced hypothermia in man. Br Heart J 1957; 19: 59-66.

27. Yan GX, Lankipalli RS, Burke JF, Musco S, Kowey PR: Ventricular repolarization components on the electrocardiogram: Cellular basis and clinical significance. J Am Coll Cardiol 2003; 42: 401-409.

28. Atarashi H, Ogawa S, Harumi K, Hayakawa H, Sugimoto T, Okada R, Murayama M, Toyama J: Characteristics of patients with right bundle branch block and ST-segment elevation in right precordial leads. Am J Cardiol 1996; 78: 581-583.

29. Antzelevitch C, Brugada P, Brugada J, Brugada R, Towbin JA, Nademanee K: Brugada syndrome: 1992-2002: a historical perspective. J Am Coll Cardiol 2003; 41: 1665-1671.

30. Brugada R, Brugada J, Antzelevitch C, Kirsch GE, Potenza D, Towbin JA, Brugada P: Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation 2000; 101: 510-515.

31. Krishnan SC, Antzelevitch C: Flecainide-induced arrhythmia in canine ventricular epicardium: Phase 2 reentry? Circulation 1993; 87: 562-572.


Repository Staff Only: item control page