THE SIGNIFICANCE OF SPLITTING OF THE P-WAVE IN THE ELECTROCARDIOGRAM
Authors: George Bachmann
Journal: Annals of Internal Medicine (1941)

Case Reports1 March 1941THE SIGNIFICANCE OF SPLITTING OF THE P-WAVE IN THE ELECTROCARDIOGRAMGEORGE BACHMANN, M.D., F.A.C.P.GEORGE BACHMANN, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-14-9-1702 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNotching, bifurcation and splitting of the P-wave have been observed in a variety of cardiac conditions. The feature which is common to all and which is responsible for the abnormality can best be understood by considering a few facts relative to the time of onset of the contraction of the two auricles and the modifications that follow experimental interference with the spread of the wave of excitation from one auricle to the other.An old observation of Chauveau1made on the horse in 1894, that the right auricle contracts before the left, was confirmed experimentally by Fredericq2, 3using the...Bibliography1. CHAUVEAU A, quoted by ARLOING, S.: Modifications rares ou peu connues de la contraction des cavités du coeur sous l'influence de la section et des excitations des nerfs pneumogastriques, Arch. d. physiol. norm. et pathol., 1894, vi, 5 s., 163-171. Google Scholar2. FREDERICQ L: Sur les pulsations de la veine cave supérieure et des oreillettes du coeur chez le chien, Bull. acad. roy. d. Belg., 1901, 130-131. Google Scholar3. FREDERICQ L: La pulsation du coeur du chien est une onde de contraction qui débute dans l'oreillette droite, s'étend rapidement aux parois des deux oreillettes, puis franchit lentement le faisceau de His, pour s'irradier rapidement dans la substance des ventricules, Arch. internat. d. physiol., 1906, iv, 37-75. Google Scholar4. SCHMIDT-NIELSEN : Du prétendu synchronisme de la systole des deux oreillettes, Arch. internat. d. physiol., 1907, iv, 417-433. Google Scholar5. STASSEN : De l'ordre de succession des différentes phases de la pulsation cardiaque chez le chien, Arch. internat. d. physiol., 1907, v, 60-75. Google Scholar6. GARTEN S: Ueber die Verwendung der Differentialelektroden am Säugetierherzen, Skand. Arch. f. Physiol., 1913, xxix, 114. CrossrefGoogle Scholar7. ERFMANN : Ein Beitrag zur Kenntnis der Fortleitung des Erregungsvorganges am Warmblüterherzen, Ztschr. f. Biol., 1913, lxi, 155. Google Scholar8. LEWISMEAKINSWHITE TJPD: The excitatory process in the dog's heart. Part I. The auricles, Phil. trans. roy. soc. London., s.B., 1914, ccv, 375-420. Google Scholar9. BACHMANN G: The inter-auricular time interval, Am. Jr. Physiol., 1916, xli, 309-320. CrossrefGoogle Scholar10. PAPEZ JW: Heart musculature of the atria, Am. Jr. Anat., 1920, xxvii, 255-277. CrossrefGoogle Scholar11. ROTHBERGERSCHERF CJD: Zur Kenntnis der Erregungsausbreitung vom Sinusknoten auf den Vorhof, Ztschr. f. d. ges. exper. Med., 1927, liii, 792-835. Google Scholar12. CONDORELLI L: Experimentelle Untersuchungen über die interauriculäre Reizleitung, Ztschr. f. d. ges. exper. Med., 1929, lxviii, 516-528. CrossrefGoogle Scholar13. GROEDEL F: Verdoppelung der Vorhofzacke des Elektrokardiogramms bei a-v Block die Folge einer Längsdissoziation der Vorhöfe, oder Darstellung der Vorhofendzacke? Verhandl. d. deutsch. Ges. f. inn. Med., 1921, 494. Google Scholar14. TRENDELENBURG W: Untersuchungen über die Aktionsströme des menschlichen Herzens. II. Mitt. Ueber die Vorhofschwankung P des Elektrokardiogramms, Ztschr. f. d. ges. exper. Med., 1934, xcii, 20-29. CrossrefGoogle Scholar15. V. BOROS J: Ueber die Formveränderungen des Elektrokardiogramms infolge vorübergehender Leitungsstörung, Wien. Arch. f. inn. Med., 1930, xix, 338-350. Google Scholar16. LAUFER S: Dérivations electives des oreillettes dans le diagnostic des troubles de la fonction auriculaire, Arch. d. mal. du coeur, 1935, xxviii, 98-101. Google Scholar17. LAUFERRUBINO SA: Sull' importanza delle derivationi elettive nella diagnosi dei disturbi di conduzione del miocardioatriale, La clin. med. ital., 1936, lxvii, 363-381. Google Scholar18. ROTHBERGER CJ: Normale und pathologische Physiologie der Rhythmik und Koordination des Herzens, Ergebn. d. Physiol., 1931, xxxii, 472-820. CrossrefGoogle Scholar19. MAHAIM I: De l'anévrysme primitif de l'oreillette gauche. Troubles particuliers du rhythme cardiaque. La dissociation interauriculaire, Ann. de méd., 1927, xxi, 380-409. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Atlanta, Georgia*Presented before the Southeastern Clinical Club, February 17, 1940.From the T. T. Fishburne Laboratory of Physiology and the Emory University Hospital, Emory University School of Medicine.†The various muscle bundles connecting the two auricles have been described by Papez.10 Besides the interauricular bundle, they include chiefly the left anterior crest and the septopulmonary bundles. Both sets of fibers intermingle more or less with those of the inter-auricular bundle. 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An echocardiographic, haemodynamic, and angiographic assessment.Relationship between P Wave Form and Left Atrial Pressure and Volume in Mitral Valve DiseaseIntermittent Intra-atrial Block: Its Diagnosis, Incidence and ImplicationsNew concepts of heart blockMysterious Sudden DeathSpecialized tissues and preferential conduction in the atria of the heartThe atrial complex of the electrocardiogramAuricular electrogram in parasternal leadsThe Abnormal ElectrocardiogramThe auricular complex in coronary thrombosis 1 March 1941Volume 14, Issue 9Page: 1702-1709KeywordsElectrocardiographyHospital medicineMusclesResearch laboratories ePublished: 1 December 2008 Issue Published: 1 March 1941 PDF downloadLoading ...