P波形态多变常见于窦房结内游走性心律,窦房结-交界区游走性心律、多源性房性早搏或心动过速、房性并行性心律伴有房性融合波、房性逸搏或逸搏心律、房内差异性传导、心房梗塞、P波电交替等。其中房内差异性传导比较少见,而又具有重要意义。它常表现在异位搏动、异位心动过速或并行心律之后,一个或连续数个窦性P波的形态发生改变。本文 P wave morphological changes commonly found in the sinoatrial node walking arrhythmia, sinoatrial node junction border walking arrhythmia, multi-source atrial premature beats or tachycardia, atrial concurrent rhythm with atrial fusion, Room escape or escape heart rhythm, differential conduction within the room, atrial infarction, P wave alternating electricity. Among them, the differential transmission in the room is relatively rare, which is of great significance. It often appears in ectopic beats, ectopic tachycardia or parallel heart rhythm, one or several consecutive sinus P wave morphological changes. This article