A case of widely split double P waves with marked intra-atrial conduction delay

Kyoko Soejima, Hideo Mitamura, Toshihisa Miyazaki, Makoto Akaishi, Shunnichiro Miyoshi, Satoshi Ogawa, Masato Tani, Ken Shinnmura, Yoshiro Nakamura

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 V1. The first P wave represented activation of the lateral wall of the right atrium, and the latter P wave represented activation of the medial 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.

Original languageEnglish
Pages (from-to)1296-1301
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume8
Issue number11
DOIs
Publication statusPublished - 1997 Jan 1

Keywords

  • Crista terminalis
  • Double P waves
  • Double potential
  • Eustachian ridge
  • Fragmented potential
  • Isthmus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'A case of widely split double P waves with marked intra-atrial conduction delay'. Together they form a unique fingerprint.

  • Cite this

    Soejima, K., Mitamura, H., Miyazaki, T., Akaishi, M., Miyoshi, S., Ogawa, S., Tani, M., Shinnmura, K., & Nakamura, Y. (1997). A case of widely split double P waves with marked intra-atrial conduction delay. Journal of Cardiovascular Electrophysiology, 8(11), 1296-1301. https://doi.org/10.1111/j.1540-8167.1997.tb01021.x