Intraatrial conduction disturbances: vectorcardiographic patterns.

Frank P loop vectorcardiograms were recorded in 30 normal subjects and in 40 patients who had intraatrial conduction disturbances alone or in association with cardiac disease. High magnification of the P loop (0.1 mv = 3 cm) permitted accurate measurement of the P loop duration, magnitude and direction. High-frequency recordings allowed optimal evaluation of the notches, bites and conduction delays in the PsE loop. Four vectorcardiographic patterns have been selected as counterparts of the four types of enlarged P waves seen in electrocardiograms of patients with atrial conduction disturbances. When intraatrial conduction disturbances coexisted with left atrial enlargment, the PsE loop was larger and smoother. The role of partial or complete block in the specific internodal or interatrial pathways is discussed. High magnification, high-frequency vectorcardiography of the P loop seems to be the best available method for determing a specific pattern of intraatrial conduction disturbance.