missing P wave

You cannot detect any P-waves in your patient's ECG. What does this mean?

The P wave represents atrial excitation. There are two requirements for a P-wave: 1) depolarisation of the sinus node 2) successful conduction of this electrical impulse from the sinus node to the atria. If there is no P wave there is either a problem with depolarisation of the sinus node or a conduction problem from the sinus node to the atria.