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J Cardiovasc Electrophysiol. 1996 Nov;7(11):1095-111.

Predicting sudden cardiac death from T wave alternans of the surface electrocardiogram: promise and pitfalls.

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Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
MA Inst Tech, Cambridge


Sudden cardiac death remains a preeminent public health problem. Despite advances in preventative treatment for patients known to be at risk, to date we have been able to identify, and thus treat, only a small minority of these patients. Therefore, there is a major need to develop noninvasive diagnostic technologies to identify patients at risk. Recent studies have demonstrated that measurement of microvolt-level T wave alternans is a promising technique for the accurate identification of patients at risk for ventricular arrhythmias and sudden cardiac death. In this article, we review the clinical data establishing the relationship between microvolt T wave alternans and susceptibility to ventricular arrhythmias. We also review the methods and technology that have been developed to measure microvolt levels of T wave alternans noninvasively in broad populations of ambulatory patients. In particular, we examine techniques that permit the accurate measurement of T wave alternans during exercise stress testing.

[Indexed for MEDLINE]

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