Evaluating the Association between Cardiac Memory T-wave and Cardiac Resynchronization Therapy Response in Patients with Heart Failure

Background and Aims: We evaluated whether cardiac memory T-wave (CMT) is associated with reverse remodeling of left ventricular as an indicator of response to cardiac resynchronization therapy (CRT). Methods and Results: CMT was defined as a negative T-wave in right and mid precordial leads with negative wide QRS complexes before CRT implantation. We studied 100 patients (50 consecutive patients with CMT and 50 consecutive patients without CMT) who underwent CRT. Patients’ resting 12-lead ECGs before and immediately after implantation of CRT were analyzed by an electrophysiologist to confirm the presence or absence of CMT. Response to CRT was defined as at least one NYHA class decrease and ≥15% decrease in left ventricular end-systolic volume (LVESV) 6 months after CRT implantation. Patients with and without CMT were compared in terms of response to CRT. The number of patients with CMT who responded to CRT was higher in comparison to the patients without CMT (64% vs, 36%, p<0.001). In the multivariate regression model, CMT remained associated with response to CRT after adjusting for baseline characteristics [odds ratio (OR) (95% CI) 4.79 (2.01–11.43), P < 0.001]. Conclusion: There is a strong relationship between the presence of CMT as a marker of reversed ventricular remodeling and the response to CRT. Moreover, since CMT occurs just after CRT implantation, it can be considered as an early valuable predictor of response to CRT. Consequently, the presence of CMT can be administered as a measure of response to CRT.