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[Cardiac memory following pacemaker implantation]
Wolfram Grimm1, Kathrin Luck2, Brandon Greene3
1Universitätsklinik Marburg, Klinik für Innere Medizin - Kardiologie, Angiologie und Intensivmedizin, UKGM Gießen und Marburg, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland. grimmw@med.uni-marburg.de.
Background:
Although T wave inversions due to cardiac memory were described already 50 years ago, little is known about the prevalence and about clinical predictors of this phenomenon.
Methods:
After exclusion of 238 patients due to bundle branch block or pacemaker dependency, a total of 325 consecutive patients were enrolled in this study during routine outpatient control of their pacemaker. A 12-lead standard ECG was obtained in all patients during transient inhibition of pacing therapy.
Results:
Cardiac memory could be documented in 115 of 325 patients (35%) and showed a strong association with the amount of ventricular stimulation. The prevalence of cardiac memory was 9% in patients with ≤25% ventricular stimulation and 86% in patients with ≥75% ventricular stimulation.
Discussion:
Cardiac memory was observed in one third of patients following pacemaker implantation. The prevalence of cardiac memory in the ECG with intrinsic rhythm is above 80% in patients with frequent ventricular stimulation. Cardiac memory due to ventricular stimulation is benign and should not be confused with similar T wave inversions due to acute coronary syndrome, severe left ventricular hypertrophy, or myocarditis.
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