ABNORMAL P WAVES AND PAROXYSMAL TACHYCARDIA

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Abstract
In routine electrocardiograms taken between attacks, abnormal P waves were found in 43 of 200 patients with paroxysmal tachycardia and hearts that were clinically normal. The abnormal P waves were usually seen in lead II and the main features were increased duration, usually to 0.12 sec, and notching, which was sometimes very striking. These features suggest that the abnormality lies in the left atrial component of the P wave. There is some suggestion that these abnormalities are related to age and are the result of a paroxysm particularly when the arrhythmia is due to atrial fibrillation. The evidence on these points however is inconclusive. No relation was found between abnormal P waves and the heart rate during a paroxysm, the average duration of an attack, or the total length of history. The presence of these abnormal P waves is of some value in confirming a retrospective clinical diagnosis of paroxysmal tachycardia.