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Challenges in Clinical Electrocardiography |

Large T-Wave Inversion in a Patient With a Pacemaker—Discussion

Arch Intern Med. 2011;171(15):1315-1316. doi:10.1001/archinternmed.2011.359.
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Correspondence: Laszlo Littmann, MD, Department of Internal Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232 (Laszlo.Littmann@carolinashealthcare.org).

Financial Disclosure: None reported.

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Figure 1. Admission and second-day electrocardiograms (ECGs). A, Admission ECG demonstrating sinus P waves tracked by a ventricular pacer at a long atrioventricular delay. B, A second ECG the following day shows a slightly faster sinus rate, shorter PR intervals, and normal, nonpaced QRS complexes. There are deep negative T waves in the inferior leads and in the anterolateral chest leads. Leads I and aVL are spared.

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Figure 2. Gradual resolution of the post-pacing T-wave abnormality over 2 weeks.




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