Microvolt T-wave alternans: A review of techniques, interpretation, utility, clinical studies, and future perspectives

Haghjoo, Majid; Arya, Arash; Sadr‐Ameli, Mohammad Ali

doi:10.1016/j.ijcard.2005.06.049

Cited by 20 publications

(21 citation statements)

References 97 publications

(159 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The standard way of measuring mTWA is via a spectral method (for a review see Ref. 14). This records 128 consecutive beats during exercise (usually pedaling).…”

Section: Introductionmentioning

confidence: 99%

Dialysis‐Dependent Changes in Ventricular Repolarization

Green

Batchvarov

Wijesekara

et al. 2012

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…The standard way of measuring mTWA is via a spectral method (for a review see Ref. 14). This records 128 consecutive beats during exercise (usually pedaling).…”

Section: Introductionmentioning

confidence: 99%

Dialysis‐Dependent Changes in Ventricular Repolarization

Green

Batchvarov

Wijesekara

et al. 2012

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…Reasons to waiver a TWA test were (1) atrial fibrillation or atrial flutter at the moment of implantation, (2) a paced ventricular rhythm, (3) recent (cardiovascular) surgery (less than 1 month because of potential sternum instability) and (4) the inability to perform exercise due to heart failure or comorbidities [9,10]. The aim of our analysis is to determine the number of patients not able to perform a TWA test due to these patient-related factors.…”

Section: Study Populationmentioning

confidence: 99%

Is T-Wave Alternans Testing Feasible in Candidates for Prophylactic Implantable Defibrillators?

et al. 2010

View full text Add to dashboard Cite

Aims Previous studies have demonstrated that microvolt T-wave alternans (TWA) screening in patients with ischaemic and dilated cardiomyopathy is effective in identifying patients at high or low risk of sudden cardiac death. It remains unclear which percentage of potential recipients of an implantable cardioverter defibrillator (ICD) are able to perform TWA testing using an exercise protocol which is, at this moment, the golden standard. In this study, we evaluated the feasibility of TWA in the risk stratification of potential ICD recipients with ischaemic or dilated cardiomyopathy. Methods and Results Medical charts of 165 primary prevention ICD recipients were reviewed to decide if patients were able to perform a TWA exercise test or not. Reasons to waiver a test were: atrial fibrillation or flutter, pacemaker dependency, recent (cardiovascular) surgery (<1 month) and inability to exercise. Of the potential ICD recipients 35% had one or more of these contraindications and were therefore not suitable for testing. Conclusion In several studies, TWA is a promising risk stratifier for predicting sudden cardiac death; however, in our population, 35% of the potential ICD candidates could not be tested. In order to fulfil its promise as a predictor for SCD, an alternative means to measure TWA needs to be evaluated.

show abstract

“…28 Visible ''macroscopic'' TWA was first reported by Herring in 1909 and, even with very low incidence, has subsequently been associated with a high risk of ventricular tachyarrhythmias in patients with familial LQTS 29 and acute coronary ischemia. 30Y32 With the development of new computer-processing techniques, TWA on the order of a few microvolts, termed MTWA, can be detected.…”

Section: Microvolt T Wave Alternansmentioning

confidence: 99%

“…Arrhythmogenic mechanisms associated with T wave alternans have also been hypothesized elsewhere. 28,36,37 The MTWA assessment method is described in detail by Rosenbaum et al 38 In brief, MTWA is not generally present at rest even in patients at risk of ventricular tachyarrhythmias, and therefore, a noninvasive exercise test or invasive atrial pacing is used to increase the heart rate. Results of a recent study suggested that the accuracy of invasive MTWA assessment may be inferior to the noninvasive approach.…”

Section: Microvolt T Wave Alternansmentioning

confidence: 99%

Electrocardiographic Evaluation of Cardiovascular Status

Wung

Kozik

2008

Journal of Cardiovascular Nursing

View full text Add to dashboard Cite

The electrocardiogram (ECG) is indispensable for the diagnosis and management of patients with a wide variety of cardiac and noncardiac diseases. The purpose of this paper is focused on recent research that used ECG, specifically the long-QT interval and microvolt T wave alternans, for the evaluation of life-threatening ventricular arrhythmias. Although remaining to be validated, QT prolongation along with other emerging electrocardiographic indices such as T wave morphology, T peak-to-T end time, or beat-to-beat QT variability may be sensitive indicators of malignant polymorphic ventricular tachyarrhythmia, torsade de pointes. Microvolt T wave alternans may provide important information in identifying a low-risk group with left ventricular dysfunction who is unlikely to benefit from unnecessary prophylactic implantable cardioverter defibrillator therapy. These ECG markers have the potential to aid in the safe administration of individualized medications, avoidance of sudden cardiac death, and provision of a noninvasive strategy to identify patients who are most and least likely to benefit from expensive prophylactic implantable cardioverter defibrillator placement.

show abstract

Microvolt T-wave alternans: A review of techniques, interpretation, utility, clinical studies, and future perspectives

Cited by 20 publications

References 97 publications

Dialysis‐Dependent Changes in Ventricular Repolarization

Dialysis‐Dependent Changes in Ventricular Repolarization

Is T-Wave Alternans Testing Feasible in Candidates for Prophylactic Implantable Defibrillators?

Electrocardiographic Evaluation of Cardiovascular Status

Contact Info

Product

Resources

About