Abstract
The present study was performed to evaluate the specificity of twin peaked P wave (TWPP) for left atrial overload (LOA) in orthogonal ECGs. A total of 2093 ECGs recorded with Frank's corrected orthogonal leads were used for analysis. It can be concluded from the present study that (1) TWPP is diagnostically non-specific and its mere existence cannot imply the existence of LAO, and (2) a time interval between the beginning of the P wave and the second peak in lead Y of more than 76 msec, is the most useful parameter available for identifying LAO, especially mitral value disease.
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