The multiple electrocardiographic manifestations of ventricular repolarization memory.
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.
Pablo A
PA
Chiale
Daniel
D
Etcheverry
Julio D
JD
Pastori
Pablo A
PA
Fernandez
Hugo A
HA
Garro
Mario D
MD
González
Centro de Arritmias Cardíacas de la Ciudad Autónoma de Buenos Aires. Cardiology Division. Hospital J.M. Ramos Mejía. Buenos Aires. Argentina. pablochiale@gmail.com.
Marcelo V
MV
Elizari
D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D017115:Catheter Ablation; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D011226:Pre-Excitation Syndromes / Q000503:physiopathology; D013610:Tachycardia / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000503:physiopathology