title: Changing P-wave morphology: What is the mechanism?
abstract: A 76-year-old woman, affected by drugs resistant focal atrial tachycardia, underwent a catheter ablation procedure in our Hospital. During ablations we observed on the surface ECG a progressive modification of the second component of the P wave (delayed and then negative in inferior leads). These findings demonstrated, compared to the beginning of the procedure, a different propagation of the activation wave from the right to the left atrium, helped to identify the true origin of a focal atrial tachycardia. Moreover, this case underlined the importance of the Bachmann's bundle for the impulse propagation through the interatrial septum in normal hearts.
authors.affiliation: Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Zedda
authors.affiliation: Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany. Electronic address: torrifederica28@gmail.com.
authors.forename: Federica
authors.initials: F
authors.lastname: Torri
authors.affiliation: Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
authors.forename: Livio
authors.initials: L
authors.lastname: Bertagnolli
authors.affiliation: Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
mesh_terms: D000368:Aged; D017115:Catheter Ablation; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology* / Q000601:surgery*; D006346:Heart Septum / Q000503:physiopathology; D006801:Humans; D013617:Tachycardia, Supraventricular / Q000503:physiopathology* / Q000601:surgery*
keywords: Advanced interatrial block; Bachmann's bundle; Catheter ablation; Focal atrial tachycardia; P wave morphology