Clinical Practice and Cases in Emergency Medicine

Introduction: Cardiac memory refers to T-wave inversions that result when normal ventricular activation resumes following a period of abnormal ventricular activation.

Case Report: We present a case of a 29-year-old man with a pacemaker who presented with new, deep symmetric T-wave inversions caused by cardiac memory.

Discussion: Abnormal ventricular activation is most commonly induced by ventricular pacing but can also occur in the setting of transient left bundle branch blocks, ventricular tachycardia, and intermittent ventricular pre-excitation.

Conclusion: Recognition of this phenomenon may help to reduce unnecessary admissions, cardiac testing, and cardiac catheterizations.