P-mitrale - ECG

P-mitrale occurs in hypertrophy of the left heart atrium. The P wave is a prolonged and biphasic (bifid). It is best seen in leads I, II and aVL and sometimes possibly in leads V5 and V6.

 

P-mitrale - ECGThis ECG contains a biphasic P wave best seen in leads I, II and V6, (red).
 

Conclusion: Due to the above-mentioned association with enlargement of the left atrium P-mitrale often precedes the atrial fibrillation occurrence. It is therefore appropriate to perform an echocardiography and check the ECG in time.