Atrial repolarization as observable in the PQ interval

Objective: To study the involvement of atrial repolarization in body surface potentials. Methods: Electrocardiograms of healthy subjects were recorded using a 64-lead system. The data analysis focused on the PQ intervals, while devoting special attention to the low-amplitude signals during the PQ segment: the segment from the end of the P wave till onset QRS. The data were analyzed by inspecting body surface potential maps and the XYZ signals of the vector cardiogram. Results: Standard P wave features exhibited normal values. The local potential extremes were found at positions not sampled by the standard leads. The PQ segment was found to be not iso-electric, the potential distribution being very similar to that at the timing of apex P but for a reversed polarity and a 3-fold lower magnitude. Conclusion: The results demonstrate a significant involvement of atrial repolarization during the PQ interval, with essentially non-concomitant “atrial T waves”.