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A Case of Widely Split Double P Waves with Marked Intra‐Atrial Conduction Delay
Author(s) -
SOEJIMA KYOKO,
MITAMURA HIDEO,
MIYAZAKI TOSHIHISA,
AKAISHI MAKOTO,
MIYOSHI SHUNNICHIRO,
OGAWA SATOSHI,
TANI MASATO,
SHINNMURA KEN,
NAKAMURA YOSHIRO
Publication year - 1997
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1997.tb01021.x
Subject(s) - crista terminalis , atrium (architecture) , medicine , right atrium , thermal conduction , anatomy , electrical conduction system of the heart , sinus rhythm , cardiology , p wave , electrocardiography , atrial fibrillation , catheter ablation , physics , thermodynamics
Widely Split Double P Wave. We report a 78‐year‐old man as the first documented case of double P waves separated by 400 msec on 12‐lead ECG. These P waves had different polarities on lead V 1 . The first P wave represented activation of the lateral wall of the right atrium, and the latter P wave represented activation of the nudial right atrium and the left atrium. Widely spaced double potentials were recorded craniocaudally along the line, presumably corresponding to the crista terminalis during sinus rhythm. For this to occur, conduction disturbance has to be present both in the upper and lower right atrium. Conduction disturbance in the upper right atrium would interrupt excitation from the sinus node to the medial wall, and conduction disturbance in the lower right atrium would interrupt excitation spreading from the lower lateral right atrium to the isthmus area where fragmented potentials were recorded. These multiple discrete lesions appear to constitute a unique electrical atriopathy in this patient.