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Left Atrial Enlargement Left Atrial Enlargement (Example 1) Left Atrial Enlargement (Example 2) Left Atrial Enlargement with P-Mitrale (Example) When left atrial enlargement occurs, it takes longer for cardiac action potentials to travel through the atrial myocardium, thus the P wave length becomes longer. Thus the criteria for diagnosing LAE on ECG is as follows: 1) The P wave length in lead II greater than 120 milliseconds OR 2) The downward deflection of the P wave in lead V1 greater than 40 milliseconds in length AND greater than 1 millimeter negative deflection (less than -1 millimeter in amplitude).  |
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