Chatterjee Phenomenon: A Demonstration of Cardiac Memory in Paced Rhythms
  • Jason Kuniyoshi
    Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
  • Maggie Kwock
    Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
  • Krixie Silangcruz
    Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
  • Witina Techasatian
    Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
  • Yoshito Nishimura
    Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA

Keywords

Cardiac memory, T-wave inversion, pacemaker

Abstract

Introduction: While T-wave inversions (TWI) are associated with various pathologies, they are rarely associated with cardiac memory, termed the Chatterjee phenomenon.

Case: A 76-year-old man with sick sinus syndrome with a pacemaker presented with chest tightness and new onset TWI in his precordial leads. On admission, he tested positive for COVID-19, but remained stable and only required minimal supplemental oxygen. His troponin was only slightly elevated, and EKG showed TWI throughout his precordial leads. A previous EKG had shown normal sinus rhythm without a paced rhythm or ST wave abnormalities. Interrogation of his pacemaker revealed an AV-paced rhythm. Given his chest tightness without dynamic changes in his troponin or EKG, the symptoms were considered more likely related to his COVID-19 infection, and he was discharged home.

Discussion: Aberrancies in normal cardiac conduction can result in altered electrical activation, especially for those with AV pacemakers, leading some patients to develop cardiac memory, manifesting as TWI.

Conclusion: AV-paced rhythm and narrow QRS complexes with TWI localized to precordial leads without evidence of active cardiac ischaemia may suggest cardiac memory, termed the Chatterjee phenomenon, requiring no invasive interventions.

VIEW THE ENTIRE ARTICLE

References

  • Waks JW, Steinhaus DA, Shvilkin A, Kramer DB. Post-pacemaker T-wave inversions: cardiac memory. Am J Med 2016;129:170–172. doi:10.1016/j.amjmed.2015.09.001.
  • Aro AL, Anttonen O, Tikkanen JT, Junttila MJ, Kerola T, Rissanen HA, et al. Prevalence and prognostic significance of T-wave inversions in right precordial leads of a 12-lead electrocardiogram in the middle-aged subjects. Circulation 2012;125:2572–2577. doi:10.1161/circulationaha.112.098681.
  • Gunaseelan R, Sasikumar M, Aswin K, Nithya B, Balamurugan N, Vivekanandan M. Memory T-waves, a rare cause of T-wave inversion in the emergency department. J Emerg Trauma Shock 2020;13:312–316. doi:10.4103/jets.Jets_70_20.
  • Chatterjee K, Harris A, Davies G, Leatham A. Electrocardiographic changes subsequent to artificial ventricular depolarization. Br Heart J 1969;31:770–779. doi:10.1136/hrt.31.6.770.
  • Ghosh S, Rhee EK, Avari JN, Woodard PK, Rudy Y. Cardiac memory in patients with Wolff-Parkinson-White syndrome: noninvasive imaging of activation and repolarization before and after catheter ablation. Circulation 2008;118:907–915. doi:10.1161/circulationaha.108.781658.
  • Seibolt L, Maestas C, Lazkani M, Fatima U, Loli A, Chesser M. Rate-related left bundle branch block and cardiac memory in a patient with bradycardia: case report and literature review. Clin Cardiol 2018;41:1097–1102. doi:10.1002/clc.22997.
  • Rosenbaum MB, Blanco HH, Elizari MV, Lázzari JO, Davidenko JM. Electrotonic modulation of the T wave and cardiac memory. Am J Cardiol 1982;50:213–222. doi:10.1016/0002-9149(82)90169-2.
  • Polito SC, Giordano JA, Cooper BL. Cardiac memory-induced T-wave inversions. Clin Pract Cases Emerg Med 2020;4:181–184. doi:10.5811/cpcem.2020.1.45527.
  • Jeyaraj D, Ashwath M, Rosenbaum DS. Pathophysiology and clinical implications of cardiac memory. Pacing Clin Electrophysiol 2010;33:346–352. doi:10.1111/j.1540-8159.2009.02630.x.

    • Views: 342
    HTML downloads: 142
    PDF downloads: 321

    Published: 2023-03-18
    Issue: 2023: Vol 10 No 3 (view)

    How to cite:
    1.
    Kuniyoshi J, Kwock M, Silangcruz K, Techasatian W, Nishimura Y. Chatterjee Phenomenon: A Demonstration of Cardiac Memory in Paced Rhythms. EJCRIM 2023;10 doi:10.12890/2023_003798.

    Similar Articles

    You may also start an advanced similarity search for this article.