Studies on the analysis of auricular excitation wave by means of the precordial lead and the esophageal lead have been reported in considerable numbers. It is natually understood from the well known relationship between the theoretical bases of unipolar lead and the anatomy of the thorax that precordial leads CR1 and CR2 may represent the excitation of the right auricle, and the esophageal lead held behind the left auricle may represent that of the left auricle. Furthermore, it is expected that, when we record simultaneously the electrocardiograms of both leads and make a minute analysis of of the phase of P-wave, we can understand pretty exactly the process of conduction of excitations to and between both auricles.
Performing the simultaneous leads on thirty healthy persons, we analysed auricular excitation waves and decided the standard values of healthy persons from our measurements. Thereafter various abnormal ECG were analysed compared with them.
The result were as followed.
1. 8 patients whose standard limb lead ECG showed the prolongation and slurring of P-wave: We could distingwish left auricular dilatations from disturbances of interauricular excitatory conduction. The former showed widening of esophageal lead P, and the latter prolongation of the interval between both intrinsicoid deflections. Both showed the broadened P on standard limb lead.
2. One patient who suffered from frequent episodes of auricular premature beats: The origin of excitation and the direction of excitatory processes were made clear.
3. One patient with auricular flutter: We understood in considerable detail the state of conduction of excitation.
4. One patient with arrhythmia due to ventricular extrasystole: A small wave after extrasystolic QRS of limb leads were interpreted to be a retrograde P-wave by means of our simultaneous leads.
This method can be performed easily in daily clinic and is useful to interprete the condition of auricles.
