A CASE OF WIDELY SPLIT DOUBLE P-WAVES WITH MARKED INTRAATRIAL CONDUCTION DELAY

Widely Split Double P Wave, We report a 78-year-old man as the first d ocumented case of double P waves separated bp 400 msec on 12-lead EGG. 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 th e latter P wave represented activation of the medial right atrium and the left atrium, Widely spaced double potentials were recorded cranioc audally along the line, presumably corresponding to the crista termina lis during sinus rhythm. For this to occur, conduction disturbance has to be present both in the upper and lower right atrium, Conduction di sturbance in the upper right atrium would interrupt excitation from th e sinus node to the medial mall, and conduction disturbance in the low er right atrium would interrupt excitation spreading fi-om the lower l ateral right atrium to the isthmus area where fragmented potentials we re recorded, These multiple discrete lesions appear to constitute a un ique electrical atriopathy in this patient.