Chen-Scarabelli Carol, Scarabelli Tiziano M
VA Ann Arbor/University of Michigan Healthcare System, Ann Arbor, MI, USA.
Am J Emerg Med. 2009 Sep;27(7):898.e1-4. doi: 10.1016/j.ajem.2008.10.037.
This article presents a case report of a 74-year-old man with T-wave inversion (TwI) in atrial fibrillation noted during routine pacemaker interrogation. The patient was seen for routine pacemaker interrogation, at which time he was noted to have underlying atrial fibrillation. A12-lead electrocardiogram of the atrial fibrillation revealed significant TwIs. He was subsequently worked up for myocardial ischemia and was found to have a moderate-sized,moderate-degree inferior wall myocardial perfusion defect. He was subsequently referred for a cardiac catheterization. The cardiac catheterization revealed nonobstructive coronary artery disease. The follow-up electrocardiogram revealed persistent but attenuated TwI.The TwIs were attributed to cardiac memory, a common but infrequently recognized phenomenon of which many clinical practitioners are unaware. Cardiac memory is due to the T wave tracking the preceding abnormal QRS complex and can be induced by right ventricular pacing or arrhythmias.
本文介绍了一例74岁男性患者的病例报告，该患者在常规起搏器程控期间被发现房颤伴有T波倒置（TwI）。患者因常规起搏器程控就诊，当时发现其存在潜在房颤。房颤的12导联心电图显示明显的TwI。随后对其进行了心肌缺血检查，发现有中等大小、中度的下壁心肌灌注缺损。随后他被转诊进行心脏导管检查。心脏导管检查显示为非阻塞性冠状动脉疾病。随访心电图显示TwI持续存在但有所减轻。TwI归因于心脏记忆，这是一种常见但很少被认识到的现象，许多临床医生并不了解。心脏记忆是由于T波跟随先前异常的QRS波群，可由右心室起搏或心律失常诱发。
