Key result
Conduction system pacing can trigger cardiac memory presenting as new T-wave inversions mimicking ischemia.
Why the study?
Cardiac memory can cause altered T-wave morphology resembling ischemic changes on the electrocardiogram following abnormal depolarization, requiring clinician awareness when interpreting findings.
Case Report (n=1)
Cardiac memory after conduction system pacing can cause new-onset T-wave inversions that mimic ischemia, highlighting the importance of reviewing prior ECGs.
May mimic ischemia post-pacing, warranting prior ECG review; hypothesis-generating and requires prospective validation.
Cardiac memory is a highly prevalent condition observed in clinical practice. It typically arises after a period of abnormal depolarization, which can occur with right ventricular pacing, intermittent left bundle branch block, ventricular tachycardia, or intermittent preexcitation. It may also develop following catheter ablation of a manifest accessory pathway. Once normal conduction is restored, the T-wave retains a “memory” of the QRS vector from the previously aberrantly conducted complexes. This altered T-wave morphology can sometimes resemble ischemic changes on the electrocardiogram, making it essential for clinicians to be aware of prior electrocardiographic patterns when interpreting current findings. Here, we report a case of cardiac memory manifesting as new-onset T-wave inversion after conduction system pacing.
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Amit Mandal (2026) conducted a case report in Cardiac memory (n=1). Conduction system pacing was evaluated on New-onset T-wave inversion. Conduction system pacing can lead to cardiac memory manifesting as new-onset T-wave inversion, which may resemble ischemic changes on the electrocardiogram.
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