Abstract
Activation of the canine atria from the region of the coronary sinus or A-V node did not result in inversion of the P wave in electrocardiographic leads II, III and aVF unless there was concomitant damage to atrial myocardium. The results obtained suggest that when the P wave is inverted in these leads, one should suspect that intra- or interatrial conduction defects coexist with ectopic or retrograde activation of the atria. The absence of change in P wave polarity in leads II, III and aVF or significant change in mean electrical axis of the P wave during activation of the atria which originates in the coronary sinus or A-V nodal regions is believed to depend on the function of specialized intra-atrial conducting paths.
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