Nikulin IA, Iurenev AP, Fofanova TV. Kardiologiia 1993;33(6):62-4. A total of 57 males with stage-II hypertensive disease were studied to diagnose latent atrial disturbances of cardiac rhythm. Holter monitoring showed that latent atrial arrhythmias were diagnosed in 82.4% of patients. There was a significant correlation between the incidence of atrial arrhythmias and the left atrial dimension defined at echocardiography. A dilatation of the left atrium of greater than 4.0 cm serves a factor that predisposes to frequent atrial extrasystoles and atrial tachycardias. The electrical instability of a dilated left atrium was evidenced by diagnostic transesophageal cardiac pacing which readily induced persistent paroxysms of atrial fibrillations in patients with enlarged left atrium. The simultaneous use of Holter monitoring and diagnostic transesophageal cardiac pacing in the outpatient setting enhances their diagnostic value in detecting latent atrial arrhythmias in patients with hypertensive disease.