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Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass
Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass
Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass
Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass
In certain circumstances, new T-wave inversions are not pathological. A 72-year-old
woman with hypertension, paroxysmal atrial fibrillation, atrial flutter, and tachycardia-bradycardia
syndrome developed frequent symptomatic conversion pauses and underwent uneventful
implantation of a dual chamber pacemaker. Her electrocardiogram (ECG) prior to pacemaker
implantation is shown in Figure 1. One week after pacemaker implantation, the patient returned for a routine medical
appointment. A repeat ECG demonstrated new, diffuse T-wave inversions (Figure 2). The patient had no chest discomfort, dyspnea, or other specific symptoms.
Figure 1Prior to pacemaker implantation, the patient's baseline electrocardiogram (ECG) disclosed
sinus rhythm with premature atrial contractions, narrow QRS complexes, and normal
T-wave orientation.
