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

Haghjoo, M. and Arya, A. and Sadr-Ameli, M.A. (2006) Microvolt T-wave alternans: A review of techniques, interpretation, utility, clinical studies, and future perspectives. International Journal of Cardiology, 109 (3). pp. 293-306.

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Microvolt T-wave alternans (TWA) testing involves measuring variation in the morphology of the T-wave on an every other beat basis. The magnitude of the variation observed is typically on the order of a few microvolts. Thus in order to detect microvolt TWA, specialized recording and signal processing methods must be employed for reliable measurement. Additionally, microvolt TWA is not generally present at rest even in patients at risk of ventricular tachyarrhythmias and therefore exercise stress, pharmacologic stress, or atrial pacing must be utilized in order to elevate the heart rate. A positive MTWA test is one in which sustained TWA is present with an onset heart rate � 110 bpm. With current instrumentation, microvolt TWA represents an inexpensive, convenient non-invasive testing modality. Microvolt TWA has been evaluated prospectively in a variety of patient populations as a means of predicting occurrence of ventricular tachyarrhythmic events and its association with the genesis of ventricular arrhythmias has been demonstrated. Future role of microvolt TWA testing in noninvasive risk stratification is awaiting results of ongoing clinical trials. In this article, we tried to review the techniques, interpretation, indications, clinical studies, and future perspectives of microvolt TWA. © 2005 Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Additional Information: cited By 16
Uncontrolled Keywords: amiodarone; beta adrenergic receptor blocking agent; calcium; calcium channel blocking agent; diltiazem; disopyramide; esmolol; flecainide; lidocaine; metoprolol; potassium channel blocking agent; procainamide; sodium channel blocking agent; sotalol; verapamil, adrenergic system; artifact reduction; bicycle ergometry; calcium cell level; calcium homeostasis; congestive cardiomyopathy; coronary artery disease; diagnostic accuracy; diagnostic approach route; diagnostic test; ECG abnormality; electrocardiogram; Fourier transformation; heart cycle; heart muscle ischemia; heart rate; heart rate variability; heart repolarization; heart ventricle fibrillation; human; hypertrophic cardiomyopathy; intermethod comparison; microvolt t wave alternans; non invasive measurement; nonhuman; patient assessment; Prinzmetal angina pectoris; priority journal; QRS complex; QT dispersion; QT prolongation; review; sarcoplasmic reticulum; signal averaged electrocardiography; ST segment depression; ST segment elevation; statistical significance; T wave alternans; treatment contraindication; treatment indication, Anti-Arrhythmia Agents; Biological Markers; Cardiomyopathy, Dilated; Cardiomyopathy, Hypertrophic; Electrocardiography; Heart Rate; Humans; Sympathetic Nervous System; Ventricular Fibrillation
Subjects: QW Microbiology. Immunology
QY Clinical Pathology
Depositing User: Librarian Farzaneh Dini
Date Deposited: 08 Apr 2020 05:50
Last Modified: 08 Apr 2020 05:50
URI: http://eprints.iums.ac.ir/id/eprint/12002

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