T Wave Alternans And Arrhythmogenesis In Cardiac Diseases Pdf


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15.05.2021 at 21:53
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t wave alternans and arrhythmogenesis in cardiac diseases pdf

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T-wave alternans, a manifestation of repolarization alternans at the cellular level, is associated with lethal cardiac arrhythmias and sudden cardiac death. At the cellular level, several mechanisms can produce repolarization alternans, including: 1 electrical restitution resulting from collective ion channel recovery, which usually occurs at fast heart rates but can also occur at normal heart rates when action potential is prolonged resulting in a short diastolic interval; 2 the transient outward current, which tends to occur at normal or slow heart rates; 3 the dynamics of early after depolarizations, which tends to occur during bradycardia; and 4 intracellular calcium cycling alternans through its interaction with membrane voltage.

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Optimizing Ambulatory ECG Monitoring of T-Wave Alternans for Arrhythmia Risk Assessment

T-wave alternans: clinical performance, limitations and analysis methodologies. Euler V. Pereira Filho I. Mailing address. Accurate recognition of individuals at higher immediate risk of sudden cardiac death SCD is still an open question. On the mechanism of SCD, a dynamical electrical instability would better explain the rarity of the simultaneous association of a correct trigger and an appropriate cardiac substrate. Several studies have been conducted trying to measure this cardiac electrical instability or any valid surrogate in an ECG beat stream.

T-Wave Alternans and Arrhythmogenesis in Cardiac Diseases

Metrics details. The occurrence of T-wave alternans in electrocardiographic signals was recently linked to susceptibility to ventricular arrhythmias and sudden cardiac death. Thus, by detecting and comprehending the origins of T-wave alternans, it might be possible to prevent such events. Here, we simulated T-wave alternans in a computer-generated human heart model by modulating the action potential duration and amplitude during the first part of the repolarization phase. We hypothesized that changes in the intracardiac alternans patterns of action potential properties would differentially influence T-wave alternans measurements at the body surface. Body surface potential maps and lead electrocardiographic signals were then computed. In depth discrimination, the influence of epicardial layers on T-wave alternans development was significantly higher than that of mid-myocardial cells.

Click on image for details. Long QT syndrome LQTS is a congenital disorder characterized by prolongation of QT interval in the electrocardiogram ECG and a propensity to develop ventricular arrhythmias, which may lead to syncope, cardiac arrest or sudden death. T-wave alternans TWA , a phenomenon of beat-to-beat variability in the repolarization phase of the ventricles, has been closely associated with an increased risk of ventricular tachyarrhythmic events VTE and sudden cardiac death SCD. Correspondence Address : Dr. Video-assisted thoracoscopic left cardiac sympathetic denervation: A reliable minimally invasive approach for congenital long-QT syndrome.


T-wave alternans, a manifestation of repolarization alternans at the cellular level, is associated with lethal cardiac arrhythmias and sudden.


Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Microvolt T-wave alternans MTWA , which reflects electrical dispersion of repolarization, is known to be associated with arrhythmia or sudden cardiac death in high risk patients.

More important seems to be the selection of individuals with relatively low risk of SCD in whom ICD implantation can be safely postponed. The aim of the study was to determine whether well-known, non-invasive parameters, such as microvolt T-wave alternans MTWA , baroreflex sensitivity BRS and short-term heart rate variability HRV , can be helpful in the identification of low-arrhythmic risk patients with ischemic left ventricular systolic dysfunction. Well-known, non-invasive parameters, such as MTWA, BRS and short-term HRV indices may be helpful in the identification of individuals with a relatively low risk of malignant ventricular arrhythmias among patients with ischemic left ventricular systolic dysfunction; in such persons, implantation of ICD could be safely postponed. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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3 Comments

Zoe N.
16.05.2021 at 04:04 - Reply

Considerable scientific data support the potential value of T-wave alternans TWA as anindex of vulnerability to ventricular fibrillation.

Alex G.
16.05.2021 at 14:52 - Reply

PDF | T-wave alternans, a manifestation of repolarization alternans at the cellular level, is associated with lethal cardiac arrhythmias and.

Baldomero T.
18.05.2021 at 10:43 - Reply

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