Abnormal atrial activation is common in patients with arrhythmogenic right ventricular cardiomyopathy

The Electrocardiographic Manifestations of Arrhythmogenic Right Ventricular Dysplasia

“…P wave abnormalities are common in ARVD [66]. Notched, widened (P wave duration >110 ms), flat or small peaked P wave are seen in up to 50% of ARVD patients in our study cohort consisting of 120 adults and 20 children.…”

P-Wave Morphology Is Unaffected by Atrial Size: A Study in Healthy Athletes

“…These were transformed into derived vectorcardiograms (dVCGs), using the inverse Dower transform, to enable orthogonal lead analysis. 1,2,4 Recordings with less than three P-waves in the largest P-wave cluster were excluded from further analyses. A 50-Hz band-stop filter was used to reduce power line interference.…”

“…Previously, it has been shown that type 1 may be considered the "healthiest," 3 while type 2 is significantly more common among patients with lone paroxysmal atrial fibrillation, 19 and that both type 2 and 3 morphologies are more common among patients with hypertrophic cardiomyopathy. 1,2 It is reasonable to believe that the morphology of the initial part of the P-wave primarily depends on the variable location of the atrial pacemaker region, 20 while the terminal part of the P-wave to a large extent is determined by the left atrial depolarization sequence, largely depending on the transseptal interatrial conduction path. 2 The three different P-wave morphologies are likely to, at least in part, represent different atrial depolarization paths.…”

“…1,2 In a population with reduced left ventricular function, abnormal P-wave morphology has been shown to be associated with the development of atrial Holmqvist et al reported significantly larger left atrial diameters in hypertrophic cardiomyopathy patients with P-wave morphology consistent with complete atrial block, but no difference between patients with other P-wave morphologies. 1,2 In a population with reduced left ventricular function, abnormal P-wave morphology has been shown to be associated with the development of atrial Holmqvist et al reported significantly larger left atrial diameters in hypertrophic cardiomyopathy patients with P-wave morphology consistent with complete atrial block, but no difference between patients with other P-wave morphologies.…”

Atrial arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy: Prevalence, echocardiographic predictors, and treatment

“…However, the latter is still a plausible explanation in some patients given that AA may occur earlier in the course of the disease . Similarly, longer P wave durations and abnormal P wave morphology have been observed in patients with ARVC unrelated to RV dilation, which may suggest that desmosomal mutations may directly affect the atrial myocardium . Future studies may clarify this question by analyzing atrial tissue from transplanted hearts or at the time of autopsy given that atrial fibrofatty infiltration has been reported both in animal models and in humans .…”