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[Pseudoischemic T waves: a possible electrophysiologic mechanism].
A Capucci1, M Baroni, G Boriani
1Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Bologna.
Cardiologia (Rome, Italy)
|March 1, 1990
Summary
This study in patients with pseudoischemia found conduction delays in the heart's electrical system. These delays, particularly in left ventricular activation, may cause T-wave inversion abnormalities.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Patients with T-wave inversion and no organic heart disease present a diagnostic challenge.
- Understanding the cardiac conductive system's role in these cases is crucial.
Purpose of the Study:
- To investigate electrophysiologic properties of the cardiac conductive system in patients with stable T-wave inversion.
- To identify potential mechanisms underlying pseudoischemia in these patients.
Main Methods:
- Electrophysiologic study in 7 patients with precordial T-wave inversion.
- Assessment of conduction delays (HV interval, ventricular activation time) at baseline and after ajmaline administration.
- Evaluation of repolarization during atrial pacing and His bundle pacing.
Main Results:
- Conduction delays (absolute or relative) were observed in the His-Purkinje system.
- Repolarization normalized with atrial extrastimuli correlating with shortened ventricular activation time.
- T-wave inversion preceded left bundle branch delay during His bundle pacing.
Conclusions:
- Conduction delays in the left-sided initial QRS vectors may cause pseudoischemia.
- Amplified electrical gradients between ventricles due to delayed left-sided activation are hypothesized to underlie repolarization abnormalities.