Key result
Deep T-wave inversions in a patient with a ventricular pacemaker were attributed to cardiac memory following a significant increase in pacing burden, mimicking myocardial ischemia.
Case Report (n=1)
Cardiac memory is an important, benign, and underdiagnosed cause of deep T-wave inversions in patients with pacemakers that can mimic myocardial ischemia.
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Cardiac memory should be considered before pursuing ischemia workup in paced patients with TWIs; case report leaves open need for prospective validation.
An 80-year-old male with a history of atrial fibrillation and a single-chamber ventricular pacemaker presented to the hospital for an elective colonoscopy. He experienced a transient episode of unresponsiveness with seizure-like activity before the procedure. This prompted him to get an EKG showing deep T-wave inversions (TWIs) in the precordial leads on a background of paced beats. Such findings were concerning for an acute and potentially life-threatening process such as myocardial infarction (MI) or intracranial insult. After ruling out any severe conditions, the EKG findings were attributed to cardiac memory, an underdiagnosed cause of deep TWIs in patients with a pacemaker.
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Naik et al. (2023) conducted a case report in Cardiac memory (n=1). Increased ventricular pacing was evaluated on Diagnosis of cardiac memory. Deep T-wave inversions in a patient with a ventricular pacemaker were attributed to cardiac memory following a significant increase in pacing burden, mimicking myocardial ischemia.
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