PMID: 9533381Apr 9, 1998Paper

Post-ventricular tachycardia P wave change simulating atrial enlargement

Journal of Electrocardiology
M P CalabròS Consolo

Abstract

An abnormal P wave was observed in a child affected by prolonged idiopathic ventricular tachycardia (fascicular tachycardia). After sinus rhythm restoration, the P wave was very tall and peaked (0.5 mV in lead II), suggesting a diagnosis of atrial enlargement. No cardiac abnormality, however, was detected by clinical and echocardiographic examination. The P wave abnormality lasted for about 1 month, with progressive voltage and shape normalization. These P wave changes were probably dependent on tachycardia; since the arrhythmia was long-lasting and characterized by atrioventricular dissociation, repetitive atrial contraction against closed atrioventricular valves caused stretching of atrial fibers, resulting in P wave abnormality. This observation suggests that very prolonged ventricular tachycardia may be associated with an electrocardiographic pattern of pseudoatrial enlargement.

References

Aug 1, 1982·The American Journal of Cardiology·M B RosenbaumJ M Davidenko
Jul 1, 1965·Circulation·T C CHOU, R A HELM

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