Reversion of cardiac memory during left bundle branch pacing
Chenghao Zhong1, Zhixin Jiang2, Xiujuan Zhou2
1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China.
Journal of Electrocardiology
|February 6, 2020
Summary
Cardiac memory (CM) involves T wave changes after abnormal heart activation. This case shows T wave inversion after right ventricular pacing, which resolved with left bundle branch pacing over 40 days.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Cardiac memory (CM) describes T wave alterations following abnormal ventricular activation.
- Temporary right ventricular apex (RVA) pacing can induce characteristic pseudo-primary T wave changes.
Purpose of the Study:
- To present a case study illustrating the phenomenon of cardiac memory.
- To observe the resolution of T wave abnormalities induced by RVA pacing during left bundle branch pacing (LBBP).
Main Methods:
- A patient underwent temporary RVA pacing for one week.
- Following RVA pacing, LBBP was initiated.
- Electrocardiographic monitoring was performed during LBBP to assess T wave changes.
Main Results:
- Temporary RVA pacing induced pseudo-primary T wave changes.
- T wave inversion persisted after cessation of RVA pacing and initiation of LBBP.
- Gradual normalization of T wave repolarization was observed over 40 days of LBBP.
Conclusions:
- Cardiac memory phenomena, characterized by T wave abnormalities, can be induced by RVA pacing.
- Left bundle branch pacing may facilitate the resolution of cardiac memory-associated T wave changes.
- This case highlights the dynamic nature of myocardial repolarization and the potential influence of pacing strategies on its recovery.
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