Document Detail

Exercise recordings for the detection of T wave alternans. Promises and pitfalls.
MedLine Citation:
PMID:  9238377     Owner:  NLM     Status:  MEDLINE    
Despite significant advances in the treatment of sudden cardiac death, many individuals still go untreated because routine clinical tests do not identify them to be at risk. Recently, a study to identify individuals at risk has shown that the presence of T wave alternans (TWA), a fluctuation in T wave morphology occurring on an every-other-beat basis, is an accurate predictor of subsequent ventricular tachyarrhythmic events. T wave alternans as low as a few microvolts was found to be significant in predicting risk. Since TWA is often detectable only at elevated heart rates, the study used atrial pacing to increase the heart rate to approximately 100 beats/min. To make TWA measurement more broadly applicable, the authors have developed a methodology that uses noninvasive physiologic stress to raise the heart rate. A particular challenge was the measurement of TWA during exercise, since the levels of noise during exercise can far exceed the levels of TWA. However, by using special multisegment Hi-Res electrodes (Cambridge Heart, Bedford, MA), noise reduction software, and a spectral method of alternans analysis, the authors have been able to reduce noise and reliably measure microvolt-level alternans. This study presents an overview of the methodology for recording and analyzing microvolt-level TWA during ergometer exercise.
P Albrecht; J Arnold; S Krishnamachari; R J Cohen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  29 Suppl     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1996  
Date Detail:
Created Date:  1997-08-19     Completed Date:  1997-08-19     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  46-51     Citation Subset:  IM    
Cambridge Heart, Bedford, MA 01730, USA.
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MeSH Terms
Cardiomyopathy, Hypertrophic / physiopathology
Electrocardiography / methods*
Exercise / physiology*
Exercise Test
Heart Rate*
Predictive Value of Tests
Tachycardia, Ventricular / physiopathology*

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