Big atria, little P waves: unexpected mismatch between chamber volume and electrocardiogram signal in 'false' atrial fibrillation

We report the case of an 81-year-old woman referred for dizziness andsuspectedatrial fibrillationandhospitalizedfor bronchopneumonia and fever. The woman was diabetic in treatment with insulin; she also had history of chronic obstructive pulmonary disease, gastrointestinal bleeding after treatment with warfarin, and hypothyroidism.