title: Critical evaluation of the twin peaked P wave ("pseudo-P mitrale") in orthogonal electrocardiograms.
abstract: The present study was performed to evaluate the specificity of twin peaked P wave (TWPP) for left atrial overload (LOA) in orthogonal ECGs. A total of 2093 ECGs recorded with Frank's corrected orthogonal leads were used for analysis. It can be concluded from the present study that (1) TWPP is diagnostically non-specific and its mere existence cannot imply the existence of LAO, and (2) a time interval between the beginning of the P wave and the second peak in lead Y of more than 76 msec, is the most useful parameter available for identifying LAO, especially mitral value disease.
mesh_terms: D001021:Aortic Valve; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D006349:Heart Valve Diseases / Q000175:diagnosis*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008943:Mitral Valve; D011656:Pulmonary Emphysema / Q000175:diagnosis