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T wave Alternans. A Marker of Vulnerability to Ventricular Tachyarrhythmias

  • N. El-Sherif
Conference paper

Abstract

Alternation of the configuration and/or duration of the repolarization wave of the electrocardiogram (ECG) — usually referred to as T wave alternans, and occasionally as ST alternans, U wave, or TU wave alternans — is seen under diverse experimental and clinical conditions (1,2). Interest in repolarization alternans is attributed to the hypothesis that it may reflect underlying dispersion of repolarization in the ventricle, a well-recognized electrophysiolgic substrate for reentrant ventricular tachyarrhythmias (3–6). Although overt T wave alternans in the ECG are not common, in recent years digital signal-processing techniques capable of detecting subtle degrees of T wave alternans have suggested that the phenomonem may be more prevalent than recognized and could represent an important marker of vulnerability to ventricular tachyarrhythmias (7–9). This report provides a brief review of the experimental and clinical conditions associated with T wave alternans and the electrophysiologic basis that links the phenomenon to ventricular vulnerability. Preliminary observations on a recently developed noninvasive technique to detect subtle T wave alternans will also be discussed (10).

Keywords

Ventricular Tachyarrhythmia Purkinje Fiber Monophasic Action Potential Early Afterdepolarization Transmembrane Action Potential 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • N. El-Sherif
    • 1
  1. 1.Health Science Center and Veterans Affairs Medical CenterCardiology Division, State University of New YorkBrooklynUSA

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