Left atrial rhythm

Left atrial rhythm – ECG

In this ECG, heart rate is 60/min and the P waves are inverted in inferior and lateral leads. These findings suggest left atrial rhythm.

Additional findings are right axis deviation suggestive of left posterior hemiblock and T wave inversion in leads I, aVL, V2-V5. qr pattern is noted in V1.

Another finding which may be seen in left atrial rhythm is ‘dome and dart’ P waves (not seen here).

But dome and dart pattern of P wave could be seen only in 2 of the 11 persons in whom left atrial rhythm was experimentally produced by left atrial pacing [1]. 

Reference

1. Harris BC, Shaver JA, Gray S 3rd, Kroetz FW, Leonard JJ. Left atrial rhythm. Experimental production in man. Circulation. 1968 Jun;37(6):1000-14.