Reversion of cardiac memory during left bundle branch pacing

Zhong, Chenghao; Jiang, Zhixin; Zhou, Xiujuan; Shan, Qijun

doi:10.1016/j.jelectrocard.2020.01.001

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…In a recent case study, Zhong et al described a similar scenario in which a prolonged period of right ventricular apical pacing followed by implantation of a left bundle branch pacing system also resulted in the development of cardiac memory. 19 These authors followed up with a subsequent retrospective study in a cohort of 398 patients undergoing placement of left bundle branch pacing leads. 20 T-wave inversions occurred in 66.3% of patients, which subsequently recovered in 87.8% of them.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Memory T-wave Inversions Noted with Ventricular Pacing: A Possible Electrocardiographic Marker of Appropriate Conduction System Pacing

COSSÚ

2023

J Innov Cardiac Rhythm Manage.

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Cardiac memory is a common condition occurring after a period of abnormal depolarization, such as with right ventricular apical pacing. With restoration of normal conduction, the T-wave “remembers” the direction of the QRS vector of the previously aberrantly conducted complexes, creating diffusely inverted T-waves on the electrocardiogram. The presence of diffuse T-wave inversions with this phenomenon may be confused with myocardial ischemia and may continue to be present for several weeks after restoration of normal conduction. Here, an interesting electrocardiogram obtained after pacemaker implantation showing the opposite effect, ie, the finding of memory T-waves occurring during pacing after a period of intrinsic atrioventricular nodal conduction, is presented. In this case, the patient had an underlying left bundle branch block, which subsequently normalized as a result of conduction system pacing. The memory T-waves became evident after pacing was performed, suggesting a potential marker for restoration of the normal ventricular activation sequence with left bundle branch pacing and normalization of the baseline intraventricular conduction defect.

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Section: Discussionmentioning

confidence: 99%

Cardiac Memory T-wave Inversions Noted with Ventricular Pacing: A Possible Electrocardiographic Marker of Appropriate Conduction System Pacing

COSSÚ

2023

J Innov Cardiac Rhythm Manage.

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“…We first demonstrated the transient and recoverable T-wave inversions (TWIs) during left bundle branch area pacing (LBBAP) in a patient with prior temporary right ventricular (RV) pacing [1]. TWIs may be caused by cardiac memory (CM).…”

Section: Introductionmentioning

confidence: 99%

Reversible T-wave inversions during left bundle branch area pacing

et al. 2022

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Background: Our clinical observation found that T-wave inversions (TWIs) appeared during left bundle branch area pacing (LBBAP); however, the incidence and influencing factors were unclear. The study aimed to investigate the effects of LBBAP on T-wave and explore possible factors associated with TWIs. Methods:This was a retrospective cohort study. An electrocardiogram (ECG) was acquired at baseline and after LBBAP. Baseline characteristics, ECG parameters, LBBAP parameters, and troponin T (TnT) levels were compared between the non-TWIs and TWIs groups. Multivariable logistic analyses were performed to adjust for potential confounders to identify the predictive factors of TWIs during LBBAP.Results: A total of 398 consecutive patients who underwent successful LBBAP were assessed for inclusion between May 2017 and Jan 2021, and 264 (66.3%) patients had TWIs. The mean (standard deviation [SD]) baseline QRS duration (QRSd) was longer in the TWIs group compared to the non-TWIs group (125.9 [34.5] ms vs. 98.2 [18.1] ms; P <0.001). Multivariable logistic regression analysis suggested that QRSd >120 ms was an independent predictor for TWIs. TWIs were partially or completely recovered in 151/172 (87.8%) patients during follow-up, the median (interquartile range [IQR]) follow-up duration was 10 days (7 days to 5.5 months). TWIs in patients with complete left bundle branch block (CLBBB) occurred more frequently in inferior wall leads (II, III, and aVF) and anterior wall leads (V1-V4) (P <0.05). Patients with complete right bundle branch block (CRBBB) were more prone to TWIs in high lateral wall leads (I and aVL) (P <0.05). There were no significant differences in TnT levels between the TWIs and non-TWIs groups.Conclusions: TWIs during LBBAP were clinically frequent and recoverable. QRSd >120 ms was independently associated with TWIs.

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Reversion of cardiac memory during left bundle branch pacing

Cited by 2 publications

References 8 publications

Cardiac Memory T-wave Inversions Noted with Ventricular Pacing: A Possible Electrocardiographic Marker of Appropriate Conduction System Pacing

Cardiac Memory T-wave Inversions Noted with Ventricular Pacing: A Possible Electrocardiographic Marker of Appropriate Conduction System Pacing

Reversible T-wave inversions during left bundle branch area pacing

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