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Biatrial Enlargement or P Biatriale

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Biatrial Enlargement or P Biatriale

P biatriale depicts an enlargement of both the right and left atria and is very rare. It occurs in patients with complex congenital heart disease or with combined disease of the heart and lungs.

The ECG in Figure 5 depicts P biatriale. Characteristics of P biatriale are:

  • Tall (> 2.5 mm) and wide (> 0.12 sec) P waves in lead II
  • Tall P waves in V2

The terminal negative portion of V1 is deep (> 1 mm) and wide (> 0.04 sec)

12-lead ECG depicting biatrial atrial enlargement.

12-lead ECG Depicting Biatrial Atrial Enlargement