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Related Experiment Videos

T wave alternans threshold in normal children.

M M Cheung1, A M Davis, R J Cohen

  • 1Department of Cardiology, Royal Children's Hospital, Parkville, Melbourne, Australia.

Journal of Cardiovascular Electrophysiology
|May 3, 2001
PubMed
Summary
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Sustained T wave alternans (TWA) is feasible in children aged 8 and up. In normal children, TWA is rare below 60% of maximum heart rate, indicating its potential as a safe biomarker.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Exercise Physiology

Background:

  • Sustained microvolt-level T wave alternans (TWA) predicts ventricular arrhythmia in adults.
  • TWA in adults is rare below 70% of predicted maximum heart rate, with onset < 110 bpm considered significant.

Purpose of the Study:

  • To assess the feasibility of TWA testing in children.
  • To determine the normal heart rate threshold for sustained TWA in pediatric populations.

Main Methods:

  • Bicycle exercise testing was performed on 100 healthy volunteers aged 8-17 years.
  • Sustained T wave alternans was evaluated during exercise.
  • Heart rate thresholds were analyzed relative to predicted maximum heart rate (220 - age).

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Main Results:

  • Noninvasive TWA assessment was feasible in 84 children (8-17 years).
  • Sustained TWA was absent in 89% of participants.
  • In children with TWA, the median onset heart rate was 138 bpm (67% of predicted maximum).

Conclusions:

  • Noninvasive TWA assessment is feasible in children aged 8 years and older.
  • Sustained TWA occurred in 11% of normal children.
  • TWA was rare below 60% of predicted maximum heart rate (1.2% of subjects).