Clinical electrocardiography . Fig. 115.—Notched P wave in Derivations II and III. a wave probably results from auricular asynchronism. von Hoesslinobserved notching of the P wave during vagus pressure in attributed the notching to delayed conduction in the sinusnode, or between the node and auricle, and believed that the firstportion of the wave was the manifestation of sinus activity. Thenotched P wave is frequently observed in mitral stenosis (Fig. 115). NEGATWE P WAVE (INVERTED)Negativity of the P wave in all derivations of the electro-cardiogram is invariably evidence of an ectop
Clinical electrocardiography . Fig. 115.—Notched P wave in Derivations II and III. a wave probably results from auricular asynchronism. von Hoesslinobserved notching of the P wave during vagus pressure in attributed the notching to delayed conduction in the sinusnode, or between the node and auricle, and believed that the firstportion of the wave was the manifestation of sinus activity. Thenotched P wave is frequently observed in mitral stenosis (Fig. 115). NEGATWE P WAVE (INVERTED)Negativity of the P wave in all derivations of the electro-cardiogram is invariably evidence of an ectopic rhythm. Ritchie,Einthoven, Fahr and deWaart, von Hoesslin, and Wilson ascribed ABNORMALITIES OF THE P WAVE 137 negativity of the P wave to a change in the cardiac pace-maker,as in auricular tachycardia, flutter, and so forth. Carter and Wedd, directing their attention to negative anddiphasic P waves in Derivation III of the electrocardiogram,concluded that the negative P waves in Derivation III fall intotwo groups: (1) wa
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