Microvolt T-Wave Alternans: Pathophysiology and Clinical Aspects

Verrier, Richard L.

doi:10.1007/978-3-030-22672-5_19

Cited by 1 publication

(1 citation statement)

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“…[22] Markedly elevated levels of T-wave alternans and fluctuations in the morphology of the ST or T-wave segments is observed in these patients, which is a marker for sudden cardiac death and these levels are doubled during seizures, which increases the risk for life-threatening arrhythmias in those who have background cardiovascular disease. [23,24] It has also been suggested that the sympathetic tone of the heart is increased as measured by HRV, and this is an independent predictor of mortality in patients with drug-resistant focal epilepsy. [22] Schomer et al, [22] measured autonomic balance with T-wave alternans, HRV and KF/HF ratio in patients with drug resistant epilepsy and used vagal nerve stimulation to modulate them.…”

Section: Neurovascular Systemmentioning

confidence: 99%

An Overview of the Utility of Autonomic Balance Measurement in Clinical Practice.

Khosravi,

Alshanfari,

Kumar

2024

Preprint

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Background: Autonomic balance measurement (ABM) is a valuable tool in clinical practice for assessing the functioning of the autonomic nervous system (ANS), which controls involuntary bodily functions. Here we summarize the current understanding of the utility of autonomic balance measurement in clinical practice. Methods: A narrative review of relevant literature was conducted, focusing on studies investigating the use of autonomic balance measures in various clinical settings. Results: ABM holds potential benefits in clinical practice, including aiding in diagnosing autonomic dysfunction, monitoring treatment efficacy, and predicting potential health complications. ABM can be crucial for diagnosing various conditions, including cardiovascular diseases (Heart failure, arrhythmias, and hypertension), neurological disorders (Parkinson's disease, Alzheimer's disease, and diabetic neuropathy), in sports medicine athletes can undergo ABM to optimize training regimens, enhance performance, assessing the impact of training stress, preventing overtraining, and promoting overall well-being and probably to assess potential health risks, in metabolic syndromes ABM can aid in the early detection of autonomic neuropathy, a diabetes-related complication, allowing for timely intervention and better management of the disease, and psychiatric disorders (Anxiety, depression, and post-traumatic stress disorder). In addition, ABM can be helpful in monitoring of treatment efficacy, by tracking changes in autonomic balance, clinicians can assess if treatments for conditions impacting the autonomic nervous system are effective. ABM can also be helpful in predicting outcomes by facilitating early recognition of future health complications in certain populations. However, limitations exist, including non-specificity, variability in measurements, and limited evidence for routine use in specific clinical settings. Conclusion: Incorporating autonomic balance measurement into routine clinical assessments provides a more comprehensive understanding of a patient's health. It complements traditional diagnostic methods, offering additional insights into the body's regulatory mechanisms. While autonomic balance measurement offers potential benefits, careful interpretation and consideration of its limitations are crucial for its effective use in clinical practice. ABM remains a valuable and versatile tool in clinical practice for a deeper understanding of the autonomic nervous system, enabling early detection, targeted interventions, and improved management of various medical conditions across different specialties.

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