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"T wave alternans" OR "MTWA"

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https://www.readbyqxmd.com/read/29194862/a-case-report-is-mexiletine-usage-effective-in-the-shortening-of-qtc-interval-and-improving-the-t-wave-alternans-in-timothy-syndrome
#1
Gulhan Tunca Sahin, Yakup Ergul
Timothy syndrome (TS) is a multisystemic disease that occurs because of a mutation in CACN1C gene and is characterized by prolonged QT interval. Mexiletine is a Class 1B antiarrhythmic drug that causes the disappearance of T-wave alternans by shortening QTc and peak-to-end of the T wave. It may block the development of torsades de pointes in a prolonged QT. This study presented the case of a patient diagnosed with TS and had a cardiac arrest history, prolonged QT, and T-wave alternans. After mexiletine treatment, the QTc interval shortened and T-wave alternans disappeared...
November 30, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29183619/non-sustained-microvolt-level-t-wave-alternans-in-congenital-long-qt-syndrome-types-1-and-2
#2
Jovil A Kannampuzha, Prasanna Sengodan, Sravani Avula, Bartholomew White, Stephen J Ganocy, Peter J Leo, Elizabeth S Kaufman
BACKGROUND: Patients with long QT syndrome (LQTS) are predisposed to polymorphic ventricular tachycardia (VT) during adrenergic stimulation. Microvolt T-wave alternans (MTWA) is linked to vulnerability to VT in structural heart disease. The prevalence of non-sustained MTWA (NS-MTWA) in LQTS is unknown. METHODS: 31 LQT1, 42 LQT2, and 80 controls underwent MTWA testing during exercise. MTWA tests were classified per standardized criteria, and re-analyzed according to the modified criteria to account for NS-MTWA...
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29126547/microvolt-t-wave-alternans-monitoring-in-a-patient-with-levofloxacin-induced-torsade-de-pointes
#3
Yuki Sahashi, Nobuhiro Takasugi, Genki Naruse, Tomoki Kubota, Kazuhiko Nishigaki, Shinya Minatoguchi
We present the case of a 62-year-old woman with levofloxacin-induced Torsade de Pointes, in whom microvolt T-wave alternans was measured during acute hospitalization and when QT interval was dynamically changing, illustrating a means for monitoring proarrhythmia.
September 27, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29108464/electrocardiographic-alterations-in-patients-consuming-synthetic-cannabinoids
#4
Hayriye M Ozturk, Mehmet Erdogan, Yakup Alsancak, Mikail Yarlioglues, Mustafa Duran, M Hamid Boztas, Sani N Murat, Selcuk Ozturk
INTRODUCTION: The aim of this study was to investigate the electrocardiographic parameters in patients consuming synthetic cannabinoids. METHODS: Thirty-five patients who were consuming synthetic cannabinoids were enrolled to the study, prospectively. The control group included 35 healthy age and sex-matched volunteers. The standard 12-lead surface electrocardiograms of the study population were recorded. P maximum (Pmax), P minimum (Pmin), P wave dispersion, interatrial duration, P wave area in D2 derivation, abnormal P terminal force in V1 derivation, heart rate, QT interval, corrected QT, QT dispersion, PR interval duration and macrovolt T-wave alternans were evaluated by two experienced cardiologists...
November 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29037423/unique-ecg-presentations-and-clinical-management-of-a-symptomatic-lqt2-female-carrying-a-novel-de-novo-kcnh2-mutation
#5
Chunlin Yin, Ping Zhang, Jing Yang, Li Zhang
A 26-year-old woman, 12 days in postpartum, developed recurrent syncope and cardiac arrest. Her ECG revealed QT-prolongation associated with LQT2-specific T-U wave patterns, T wave alternans, long QT-dependent torsade de pointes (TdP) and ventricular fibrillation (VF). She also had intermittent LBBB (80bpm) on alternate beats and RBBB at sinus tachycardia (113bpm). Family genotyping revealed a novel de novo missense mutation G604C of KCNH2. Propranolol slowed heart rate and further prolonged QT interval (610ms) that caused TdP recurrence...
August 17, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29020031/sudden-cardiac-death-and-pump-failure-death-prediction-in-chronic-heart-failure-by-combining-ecg-and-clinical-markers-in-an-integrated-risk-model
#6
Julia Ramírez, Michele Orini, Ana Mincholé, Violeta Monasterio, Iwona Cygankiewicz, Antonio Bayés de Luna, Juan Pablo Martínez, Pablo Laguna, Esther Pueyo
BACKGROUND: Sudden cardiac death (SCD) and pump failure death (PFD) are common endpoints in chronic heart failure (CHF) patients, but prevention strategies are different. Currently used tools to specifically predict these endpoints are limited. We developed risk models to specifically assess SCD and PFD risk in CHF by combining ECG markers and clinical variables. METHODS: The relation of clinical and ECG markers with SCD and PFD risk was assessed in 597 patients enrolled in the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study...
2017: PloS One
https://www.readbyqxmd.com/read/28964198/a-multichannel-decision-level-fusion-method-for-t-wave-alternans-detection
#7
Changrong Ye, Xiaoping Zeng, Guojun Li, Chenyuan Shi, Xin Jian, Xichuan Zhou
Sudden cardiac death (SCD) is one of the most prominent causes of death among patients with cardiac diseases. Since ventricular arrhythmia is the main cause of SCD and it can be predicted by T wave alternans (TWA), the detection of TWA in the body-surface electrocardiograph (ECG) plays an important role in the prevention of SCD. But due to the multi-source nature of TWA, the nonlinear propagation through thorax, and the effects of the strong noises, the information from different channels is uncertain and competitive with each other...
September 2017: Review of Scientific Instruments
https://www.readbyqxmd.com/read/28918212/an-%C3%AE-glucosidase-inhibitor-could-reduce-t-wave-alternans-in-type-2-diabetes-patients
#8
Kazuo Eguchi, Takahiro Komori, Toshinobu Saito, Satoshi Hoshide, Kazuomi Kario
BACKGROUND: We tested the hypothesis that an alpha-glucosidase inhibitor (α-GI), miglitol, is effective in protecting the cardiovascular system in type 2 diabetes mellitus (T2DM). METHODS: We studied 19 hospitalized heart disease patients with T2DM in whom we performed continuous glucose monitoring, Holter electrocardiogram, and ambulatory blood pressure (BP) monitoring simultaneously for 48h. The α-GI miglitol was administered for half of the study period by a cross-over fashion...
August 15, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#9
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
November 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28871362/electrocardiographic-markers-of-appropriate-implantable-cardioverter-defibrillator-therapy-in-young-people-with-congenital-heart-diseases
#10
Dunia Bárbara Benítez Ramos, Michel Cabrera Ortega, Jesús Castro Hevia, Margarita Dorantes Sánchez, Ailema Amelia Alemán Fernández, Osmin Castañeda Chirino, Marlenis Cruz Cardentey, Frank Martínez López, Roylan Falcón Rodríguez
Implantable cardioverter-defibrillators (ICDs) are increasingly utilized in patients with congenital heart disease (CHD). Prediction of the occurrence of shocks is important if improved patient selection is desired. The electrocardiogram (ECG) has been the first-line tool predicting the risk of sudden death, but data in CHD patients are lacking. We aim to evaluate the predictive value of electrocardiographic markers of appropriate therapy of ICD in young people with CHD. We conducted a prospective, longitudinal study, in twenty-six CHD patients (mean age 24...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28783809/macroscopic-t-wave-alternans-a-red-flag-for-code-blue
#11
Peter K Moore, Katie E Raffel, Isaac R Whitman
No abstract text is available yet for this article.
October 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28749343/a-potential-based-inverse-spectral-method-to-non-invasively-localize-discordant-distributions-of-alternans-on-the-heart-from-the-ecg
#12
Jaume Coll-Font, Burak Erem, Dana H Brooks
T-wave alternans (TWA), defined as the beat-to-beat alternation in amplitude of the T-waves, has been shown to be linked to ventricular fibrillation (VF). However, current TWA tests have high sensitivity but low specificity in determining who is at risk. To overcome this limitation, it might be helpful to determine the spatial distribution of any regions on the heart that alternate in opposite phase. Understanding these spatial distributions in relation to the regular activation of the heart could help explain the mechanism for the genesis of VF and thus disambiguate the low specificity of TWA...
July 26, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28745301/automatic-detection-of-t-wave-alternans-using-tensor-decompositions-in-multilead-ecg-signals
#13
Griet Goovaerts, Bert Vandenberk, Rik Willems, Sabine Van Huffel
OBJECTIVE: T wave alternans (TWA) is a promising non-invasive risk stratification tool for sudden cardiac death which can be detected from surface ECG. This paper proposes a novel method to automatically detect TWA based on tensor decomposition methods. APPROACH: Two different tensor decomposition approaches are examined and compared, namely canonical polyadic decomposition and the more generalized variation PARAFAC2 which allows the T waves to shift in time. RESULTS AND SIGNIFICANCE: Results on different artificial and clinical signals show that the presented methods are a robust and reliable way for TWA detection, and show the potential benefit of tensors in ECG signal processing...
July 26, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28708197/risk-stratification-personalised-model-for-prediction-of-life-threatening-ventricular-tachyarrhythmias-in-patients-with-chronic-heart-failure
#14
Alexander Vladimirovich Frolov, Tatjana Gennadjevna Vaikhanskaya, Olga Petrovna Melnikova, Anatoly Pavlovich Vorobiev, Ludmila Michajlovna Guel
BACKGROUND: The development of prognostic factors of life-threatening ventricular tachyarrhythmias (VTA) and sudden cardiac death (SCD) continues to maintain its priority and relevance in cardiology. The development of a method of personalised prognosis based on multifactorial analysis of the risk factors associated with life-threatening heart rhythm disturbances is considered a key research and clinical task. AIM: To design a prognostic and mathematical model to define personalised risk for life-threatening VTA in patients with chronic heart failure (CHF)...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28696268/personalizing-risk-stratification-for-sudden-death-in-dilated-cardiomyopathy-the-past-present-and-future
#15
REVIEW
Brian P Halliday, John G F Cleland, Jeffrey J Goldberger, Sanjay K Prasad
Results from the DANISH Study (Danish Study to Assess the Efficacy of ICDs in Patients With Non-Ischemic Systolic Heat Failure on Mortality) suggest that for many patients with dilated cardiomyopathy (DCM), implantable cardioverter-defibrillators do not increase longevity. Accurate identification of patients who are more likely to die of an arrhythmia and less likely to die of other causes is required to ensure improvement in outcomes and wise use of resources. Until now, left ventricular ejection fraction has been used as a key criterion for selecting patients with DCM for an implantable cardioverter-defibrillator for primary prevention purposes...
July 11, 2017: Circulation
https://www.readbyqxmd.com/read/28670363/verapamil-suppresses-cardiac-alternans-and-ventricular-arrhythmias-in-acute-myocardial-ischemia-via-ryanodine-receptor-inhibition
#16
Yu-Lei Deng, Jun-Yan Zhao, Ji-Hua Yao, Qiang Tang, Le Zhang, Hong-Lian Zhou, Cun-Tai Zhang, Jia-Gao Lv, Xiao-Qing Quan
T-wave alternans (TWA) is a potent arrhythmia substrate under the conditions of acute myocardial ischemia. Abnormal intracellular calcium cycling contributes to the genesis of cardiac alternans. Ryanodine receptor (RyR) is a pivotal Ca(2+) cycling protein central to Ca(2+) signaling in the heart. Here, we investigated the potential role of RyR in cardiac alternans and ventricular arrhythmias in acute myocardial ischemia. Transmembrane action potentials were simultaneously recorded from epicardium and endocardium together with a transmural ECG and isometric contraction force in the arterially perfused left ventricular wedge preparations...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28607621/epicardially-placed-implantable-cardioverter-defibrillator-for-a-child-with-congenital-long-qt-syndrome
#17
Hirotaro Sugiyama, Motomi Tachibana, Hiroshi Morita, Nobuhiro Nishii, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito
A 7-year-old boy presented at our hospital with syncope. At birth, electrocardiography had shown a long QT interval with torsade de pointes (TdP). Congenital long QT syndrome (LQTS) had been diagnosed by genetic testing, and was successfully controlled with oral propranolol. At age 7, TdP had recurred with syncope. Electrocardiography revealed a prominent long QT interval with T-wave alternans. The propranolol dose was increased, but TdP remained uncontrolled. A cardioverter-defibrillator (ICD) was implanted epicardially, and TdP completely resolved with atrial pacing...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28552120/benchmarking-of-a-t-wave-alternans-detection-method-based-on-empirical-mode-decomposition
#18
Manuel Blanco-Velasco, Rebeca Goya-Esteban, Fernando Cruz-Roldán, Arcadi García-Alberola, José Luis Rojo-Álvarez
BACKGROUND AND OBJECTIVE: T-wave alternans (TWA) is a fluctuation of the ST-T complex occurring on an every-other-beat basis of the surface electrocardiogram (ECG). It has been shown to be an informative risk stratifier for sudden cardiac death, though the lack of gold standard to benchmark detection methods has promoted the use of synthetic signals. This work proposes a novel signal model to study the performance of a TWA detection. Additionally, the methodological validation of a denoising technique based on empirical mode decomposition (EMD), which is used here along with the spectral method, is also tackled...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28526702/t-wave-morphology-restitution-predicts-sudden-cardiac-death-in-patients-with-chronic-heart-failure
#19
Julia Ramírez, Michele Orini, Ana Mincholé, Violeta Monasterio, Iwona Cygankiewicz, Antonio Bayés de Luna, Juan Pablo Martínez, Esther Pueyo, Pablo Laguna
BACKGROUND: Patients with chronic heart failure are at high risk of sudden cardiac death (SCD). Increased dispersion of repolarization restitution has been associated with SCD, and we hypothesize that this should be reflected in the morphology of the T-wave and its variations with heart rate. The aim of this study is to propose an electrocardiogram (ECG)-based index characterizing T-wave morphology restitution (TMR), and to assess its association with SCD risk in a population of chronic heart failure patients...
May 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28522367/qrs-t-wave-and-calcium-alternans-in-a-type-i-diabetic-mouse-model-for-spontaneous-postmyocardial-infarction-ventricular-tachycardia-a-mechanism-for-the-antiarrhythmic-effect-of-statins
#20
Hongwei Jin, Charles M Welzig, Mark Aronovitz, Farzad Noubary, Robert Blanton, Bo Wang, Mohammad Rajab, Alfred Albano, Mark S Link, Sami F Noujaim, Ho-Jin Park, Jonas B Galper
BACKGROUND: The incidence of sudden arrhythmic death is markedly increased in diabetics. OBJECTIVE: The purpose of this study was to develop a mouse model for postmyocardial infarction (post-MI) ventricular tachycardia (VT) in the diabetic heart and determine the mechanism of an antiarrhythmic effect of statins. METHODS: ECG transmitters were implanted in wild-type (WT), placebo, and pravastatin-treated type I diabetic Akita mice. MIs were induced by coronary ligation, and Ca2+ transients were studied by optical mapping, and Ca2+ transients and sparks in left ventricular myocytes (VM) by the Ionoptix system and confocal microscopy...
September 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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