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Subepicardial ischemia vs cardiac memory after tachycardia by intranodal reentry. case report and literature review


International Journal of Family & Community Medicine
Juan Carlos Betancourt Aldana Villarruel,1 Carlos de la Fuente Macip,2 Emmanuel Jiménez Segura,3 Eduardo Andrés Fabre Palacios,4 Karina Julissa Martínez Gómez4

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Abstract

Cardiac memory is an electrophysiological property that is expressed as persistent electrophysiological changes in response to variations in the rate and sequence of cardiac electric activation and is defined as the persistent changes of the T wave on the electrocardiogram after a period of rhythms of wide QRS widened, and that becomes evident once the normal ventricular activation pattern is restored.1 The first evidence of its existence arises from case reports where changes in the polarity of the T wave were observed after transient episodes of tachyarrhythmias. Subsequently, it was demonstrated how ventricular activation by external sources in a prolonged way induces persistent changes in the electrocardiogram, and those changes persist after eliminating this source.6,8 Electrical memory can occur in a short and long term, when it is short-term, the changes are due to the modulation of the electrical activity of individual cardiac cells or cell to cell interaction, while long-term memory involves the synthesis of proteins and / or structural changes.8

Keywords

electrical memory, long term. short term, tachyarrhythmias, T wave, ventricular activation, persistent changes, electrical activity

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