Atrial repolarization: its impact on electrocardiography.

The repolarizing T(a) wave of normal sinus rhythm is not fully visible unless there is a long P-R interval or complete atrioventicular block. Even with the latter, it is often of unseeably low voltage. It can powerfully influence inferior lead ST deviation in the stress test. The T(a) of inverted or retrograde P waves is of higher voltage than that of sinus rhythm and can simulate inferior injury. Evidence of specialized internodal tracts resides in 2 specific atrial action potential properties: resistance to gross hyperkalemia and supernormality. The T(a) wave figures essentially in the diagnosis of acute atrial infarction.