Atrial dissociation simulated by respiratory artifacts. Case report
Oreto, G.; Consolo, S.; Magazzù, G.; Arrigo, F.
Giornale Italiano di Cardiologia 10(7): 926-932
1980
ISSN/ISBN: 0046-5968 PMID: 7461344 Document Number: 168385
A case of likewise atrial dissociation in a twelve years old patient affected by mucovisclosis with severe respiratory failure is described. The classic criteria of the atrial dissociation were met in the ECG, in which, beside the sinus P waves, low P-like waves, whose rate was 69/m', were present: they did not conduct to the ventricles and were independent from the sinus rhythm. Such waves always coincided with the beginning of the inspiration, and disappeared during the apnoea. So they were not believed as being the results of electrical forces of the heart, but artifacts produced by respiratory movements. The diagnostic criteria of the atrial dissociation are discussed on the basis of these observations. the exclusion of artifacts, especially the respiratory ones, and the demonstration, obtained through the intracavitary ECG, that the waves are really produced by the heart, are necessary to diagnoses the arrhythmia. By the application of these diagnostic criteria only one of the cases found in the Literature has been accepted as demonstrative of atrial dissociation due to complete intraatrial block in man.