Persistent T-wave changes after radiofrequency catheter ablation of an accessory connection (Wolff-parkinson-white syndrome) are caused by "cardiac memory".
BACKGROUND
The purpose of this study was to determine the incidence and origin of T-wave changes after ablation of an accessory atrioventricular connection (AC), which could either be a sign of damage to the coronary circulation or a result of persistent abnormal repolarization secondary to previously abnormal ventricular activation ("cardiac memory").


RESULTS
Ninety of 107 consecutive patients (33 women and 57 men, mean age 36 +/- 5 years) undergoing successful catheter ablation of an AC were studied. Patients with bundle branch block or more than 1 AC were excluded. Sixty-four patients had manifest preexcitation (group 1) and 26 had a concealed AC (group 2). Immediately after loss of preexcitation, 38 (59%) patients with a manifest AC showed T-wave abnormalities. In contrast, none of the patients with a concealed AC had T-wave abnormalities after ablation (P <.05). The T-wave changes (1) did not correlate with the number or duration of energy applications or with markers of tissue injury; (2) correlated with the location of the AC and the degree of preexcitation, respectively; and (3) completely resolved over a period of weeks to months. None of the patients had recurrence of preexcitation or tachycardia during a mean follow-up of 16 +/- 7 months.


CONCLUSIONS
T-wave changes after ablation are most likely caused by "cardiac memory" and are not a sign of myocardial or coronary injury.
Geller
J C
JC
Division of Cardiology, University Hospitals, Otto-von-Guericke Magdeburg, Germany.
Carlson
M D
MD
Goette
A
A
Reek
S
S
Hartung
W M
WM
Klein
H U
HU
D000328:Adult; D001283:Atrioventricular Node / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000293:injuries / Q000294:innervation*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015588:Observer Variation; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery*