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Common
Diagnostic Criteria for Left and
Right Atrial Abnormalities
Left
Atrial Abnormality
-
Prolonged P
wave duration of >120 msec in
lead II
-
Prominent
notching of the P wave,
usually most obvious in lead
II, with an interval between
the notches of >40 msec (p
mitrale)
-
Ratio
between the duration of the P
wave in lead II and the
duration of the PR segment of
>1.6
-
Increased
duration and depth of the
terminal negative portion of
the P wave in lead V1 (the P
terminal force) so that the
area subtended by it exceeds
0.04 mm-sec (Morris index)
-
Leftward
shift of the mean P wave axis
to between -30 and +45 degrees
Right
Atrial Abnormality
-
Peaked P
waves with amplitudes over 250
muV in lead II (p pulmonale)
-
Rightward
shift of the mean P wave axis
to above 75 degrees
-
Increased
area under the initial
positive portion of the P wave
in lead V1 to >0.06 mm-sec
Related Criteria
Electrocardiographic Diagnosis of
Left Ventricular Hypertrophy (LVH)
More...
References:
-
Edhouse
J, Thakur RK, Khalil JM.
ABC of clinical
electrocardiography.
Conditions affecting the
left side of the heart.
BMJ. 2002 May
25;324(7348):1264-7.
[Medline]
-
Harrigan RA, Jones K.
ABC of
clinical
electrocardiography.
Conditions affecting the
right side of the heart.
BMJ. 2002 May
18;324(7347):1201-4.
[Medline]
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