Title:The Multiple Electrocardiographic Manifestations of Ventricular Repolarization Memory
VOLUME: 10 ISSUE: 3
Author(s):Pablo A. Chiale, Daniel Etcheverry, Julio D. Pastori, Pablo A. Fernandez, Hugo A. Garro, Mario D. González and Marcelo V. Elizari
Affiliation:Centro de Arritmias Cardíacas de la Ciudad Autónoma de Buenos Aires. Cardiology Division. Hospital J.M. Ramos Mejía. Buenos Aires. Argentina.
Keywords:Cardiac electrophysiology, electrocardiography, cardiac pacing, cardiac arrhythmias, memory induced T wave.
Abstract:T wave “memory” is a peculiar variety of cardiac remodeling caused by a transient change in the course of ventricular
depolarization (due to ventricular pacing, rate-dependent intraventricular block, ventricular preexcitation or tachyarrhythmias
with wide QRS complexes). It is usually manifested by inverted T waves that appears when normal ventricular
activation is restored. This phenomenon is cumulative and occurs earlier if the ventricular myocardium has previously
been exposed to the same conditioning stimuli. In this article the different conditions giving rise to “classical” T
wave memory development are reviewed and also “another” type of T wave memory is described. It is also shown that
cardiac memory may induce not only negative (pseudo-primary) T waves but also a reversal of primary and pseudoprimary
T waves leading to “normalization” of ventricular repolarization. The knowledge of these dissimilar consequences
of T wave memory is essential to assess the characteristics of ventricular repolarization.
