Persistent T-wave changes after radiofrequency catheter ablation of an accessary connection (Wolff-Parkinson-White syndrome) are caused by "cardiac memory"
Jc. Geller et al., Persistent T-wave changes after radiofrequency catheter ablation of an accessary connection (Wolff-Parkinson-White syndrome) are caused by "cardiac memory", AM HEART J, 138(5), 1999, pp. 987-993
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background The purpose of this study was to determine the incidence and ori
gin of T-wave changes after ablation of an accessory atrioventricular conne
ction (AC), which could either be a sign of damage to the coronary circulat
ion or a result of persistent abnormal repolarization secondary to previous
ly abnormal ventricular activation ("cardiac memory").
Methods and Results Ninety of 107 consecutive patients (33 women and 57 men
, mean age 36 +/- 5 years) undergoing successful catheter ablation of an AC
were studied. Patients with bundle branch block or more than 1 AC were exc
luded. Sixty-four patients had manifest preexcitation (group 1) and 26 had
a concealed AC (group 2). immediately after loss of preexcitation, 38 (59%)
patients with a manifest AC showed T-wave abnormalities. In contrast, none
of the patients with a concealed AC had T-wave abnormalities after ablatio
n (P < .05). The T-wave changes (1) did not correlate with the number or du
ration of energy applications or with markers of tissue injury; (2) correla
ted with the location of the AC and the degree of preexcitation, respective
ly; and (3) completely resolved over a period of weeks to months. None of t
he patients had recurrence of preexcitation or tachycardia during a mean fo
llow-up of 16 +/- 7 months.
Conclusions T-wave changes after ablation are most likely caused by "cardia
c memory" and are not a sign of myocardial or coronary injury.