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Translational Rabbit Model of Chronic Cardiac Pacing

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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.

Herzschrittmachertherapie & Elektrophysiologie

|September 29, 2019

Summary

Cardiac memory, a T-wave inversion phenomenon, affects one-third of pacemaker patients. Frequent ventricular stimulation significantly increases its prevalence, but it is a benign finding.

Keywords:

Cardiac memory Cardiac pacemaker Electrocardiogram T wave inversions Ventricular stimulation

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Area of Science:

Cardiology
Electrophysiology
Medical Devices

Background:

Cardiac memory, characterized by T-wave inversions, has been known for 50 years.
Limited data exists on its prevalence and clinical predictors in pacemaker patients.

Purpose of the Study:

To determine the prevalence of cardiac memory in patients with pacemakers.
To identify clinical predictors, specifically ventricular stimulation, associated with cardiac memory.

Main Methods:

325 consecutive pacemaker patients were enrolled after excluding those with bundle branch block or pacemaker dependency.
A standard 12-lead ECG was recorded during transient pacing inhibition.

Main Results:

Cardiac memory was identified in 115 out of 325 patients (35%).
A strong association was found between cardiac memory and the amount of ventricular stimulation.
Prevalence was 9% with ≤25% ventricular stimulation, rising to 86% with ≥75% ventricular stimulation.

Conclusions:

Cardiac memory affects approximately one-third of pacemaker patients.
In patients with frequent ventricular stimulation, the prevalence of cardiac memory during intrinsic rhythm exceeds 80%.
Ventricular stimulation-induced cardiac memory is benign and distinct from T-wave inversions caused by acute coronary syndrome, left ventricular hypertrophy, or myocarditis.