Noninvasive detection of patients prone to ventricular tachyarrhythmias and sudden
cardiac death using measurements of ventricular repolarization derived from the 12-lead
surface ECG has received enormous interest. Among the methods introduced for this
purpose are assessment of QT dispersion, determination of QT dynamics assessed from
long-term ECG recordings, and morphologic assessment of T-wave patterns. Analysis
of microvolt T-wave alternans has emerged as the most promising. Considerable experimental
evidence links microvolt T-wave alternans to the genesis of life-threatening ventricular
tachyarrhythmias.
1
Over the last decade, several hundred studies of microvolt T-wave alternans have
been published.
2
Evidence from these trials indicates that noninvasive assessment of microvolt T-wave
alternans is an important tool for determining the risk for ventricular tachyarrhythmic
events in patients with ischemic and nonischemic cardiomyopathy. This article reviews
the practical aspects of how microvolt T-wave alternans is assessed and analyzed in
clinical practice.To read this article in full you will need to make a payment
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References
- T-wave alternans.in: Zipes D.P. Jalife J. Cardiac Electrophysiology From Cell to Bedside. Fourth edition. WB Saunders, Philadelphia2004: 839-847
- T-wave alternans.J Cardiovasc Electrophysiol. 2005; 16: 625-628
- Dynamic tracking of cardiac vulnerability by complex demodulation of the T wave.Science. 1991; 252: 437-440
- T-wave alternans in idiopathic long QT syndrome.J Am Coll Cardiol. 1994; 23: 1541-1546
- Electrical alternans and cardiac electrical instability.Circulation. 1988; 77: 110-121
- T wave alternans during exercise and atrial pacing in humans.J Cardiovasc Electrophysiol. 1997; 8: 987-993
- Interpretation and classification of microvolt T wave alternans tests.J Cardiovasc Electrophysiol. 2002; 13: 502-512
- Microvolt T-wave alternans distinguishes between patients likely and patients not likely to benefit from implanted cardiac defibrillator therapy.Circulation. 2004; 110: 1885-1889
Article info
Publication history
Published online: July 29, 2005
Identification
Copyright
© 2005 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
