Atrial tachycardia with widely-split P waves may mimic a distinct faster atrial tachycardia with half the cycle length of the actual P-P interval

Academic Article


  • A 57-year-old man with atrial tachycardia (AT) after cavo-tricuspid isthmus ablation underwent electrophysiological testing. Mapping revealed atrial activation with a cycle length exactly twice that of the P-P interval on electrocardiogram. Electroanatomic mapping revealed an AT focus near the left superior pulmonary vein, with inter-atrial conduction occurring in the lower septum and cavo-tricuspid isthmus conduction block. A propagation map demonstrated activation going down the left atrial posterior wall and right atrial free wall, generating different positive P waves in the inferior leads. The focal AT with inter- and intra-atrial conduction block exhibited widely-split P waves misinterpreted as a distinct AT.
  • Published In

    Digital Object Identifier (doi)

    Pubmed Id

  • 25371147
  • Author List

  • Yamada T; Doppalapudi H; McElderry HT; Kay GN
  • Start Page

  • 1381
  • End Page

  • 1384
  • Volume

  • 72
  • Issue

  • 8