Right ventricular outflow tract pacing: Relation of high to low synchronous ventricular activation with cardiac memory

Cardiac memory is usually observed after right ventricular apical pacing and considered to be related to alter asynchronous activation by apical pacing. However, it is not known whether it occurs by unaltered high to low synchronous ventricular activation by right ventricular outflow tract (RVOT) pacing. We present here a case with dual chamber pacemaker whose ventricular lead positioned in the RVOT and developed cardiac memory immediately after ventricular pacing had stopped and the underlying sinus rhythm resumed.