Figure 1 - ECG case in full disclosure
Figure 2 - P waves marked
This ECG is a from a post-cardiac transplant patient. Two sets of P waves frequently results from a procedure that sutures the donor heart to the corresponding structures of the recipient residual atria. The 2 sets of P waves are usually dissociated from each other but in some cases becomes synchronized. Unusual atrial rhythms also develop particularly when one of the sets of the 2 atrial components develops ectopic activity, atrial fibrillation or atrial flutter. A complete or incomplete RBB is present in more than 80% of ECGs after transplantation.