Abstract
Five cases of partial auriculoventricular block are reported, in which those P waves which came carly in diastole constantly had an altered shape. In four of these cases, during 2:1 block, the P waves with an abnormal configuration seemed to be slightly premature. Knowledge of this disturbance will prevent confusion with blocked auricular extrasystoles. Sometimes this change of form may be due to superimposition of U waves on early P waves. Another possibility is a change in intra-auricular conduction or site of stimulus formation caused by varying vagal tone.
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