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• W2092808192 abstract "T-wave alternans (TWA) is defined as alternate-beat fluctuations in the shape and amplitude of the T-wave on the electrocardiogram (ECG). Whereas macroscopic TWA is a rare phenomenon, 1 Raeder E.A. Rosenbaum D.S. Bhasin R. et al. Alternating morphology of the QRST complex preceding sudden death. N Engl J Med. 1992; 326: 271-272 Crossref PubMed Scopus (50) Google Scholar , 2 Armoundas A.A. Nanke T. Cohen R.J. Images in cardiovascular medicine T-wave alternans preceding torsade de pointes ventricular tachycardia. Circulation. 2000; 101: 2550 Crossref PubMed Scopus (30) Google Scholar microvolt TWA can be detected by applying advanced signal processing techniques to the surface ECG such as fast Fourier transformation 3 Smith J.M. Clancy E.A. Valeri C.R. et al. Electrical alternans and cardiac electrical instability. Circulation. 1988; 77: 110-121 Crossref PubMed Scopus (435) Google Scholar or the modified moving average method. 4 Nearing B. Huang H.A. Verrier R.L. Dynamic tracking of cardiac vulnerability by complex demodulation of the T wave. Science. 1991; 252: 437-440 Crossref PubMed Scopus (285) Google Scholar There is ample evidence from experimental and computer simulation studies that TWA is mechanistically linked to the genesis of malignant ventricular tachyarrhythmias such as ventricular tachycardia or fibrillation. 5 Pastore J.M. Girouard S.D. Laurita K.R. et al. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation. 1999; 99: 1385-1394 Crossref PubMed Scopus (721) Google Scholar , 6 Walker M.L. Rosenbaum D.S. Repolarization alternans: implications for the mechanism and prevention of sudden cardiac death. Cardiovasc Res. 2003; 57: 599-614 Crossref PubMed Scopus (164) Google Scholar , 7 Hohnloser S.H. T wave alternans. in: Zipes D.P. Jalife J. Cardiac Electrophysiology From Cell to Bedside. WB Saunders Co, Philadelphia2004: 839-847 Google Scholar TWA reflects beat-to-beat alternation in the time course of the action potential duration at the cellular level. This was, for instance, established through detailed measurements of the time course of membrane voltage throughout the ventricle at a time when microscopic TWA was elicited on the surface ECG using high-resolution optical mapping techniques in a guinea pig model of pacing-induced microscopic TWA. 5 Pastore J.M. Girouard S.D. Laurita K.R. et al. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation. 1999; 99: 1385-1394 Crossref PubMed Scopus (721) Google Scholar The occurrence of discordant alternans was then associated with the occurrence of ventricular tachycardia or fibrillation. 5 Pastore J.M. Girouard S.D. Laurita K.R. et al. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation. 1999; 99: 1385-1394 Crossref PubMed Scopus (721) Google Scholar" @default.
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• W2092808192 title "T-wave alternans: A pathophysiological link to human ventricular tachyarrhythmias" @default.
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