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Pathophysiological basis and clinical application of T-wave alternans
Antonis A Armoundas1, Gordon F Tomaselli, Hans D Esperer
1Division of Molecular Cardiobiology, Johns Hopkins University, Ross 844, 720 Rutland Avenue, Baltimore, MD 21205, USA. antonis@pothos.bme.som.jhmi.edu
Journal of the American College of Cardiology
|July 11, 2002
Summary
T-wave alternans (TWA) indicates a heightened risk for life-threatening ventricular arrhythmias and sudden cardiac death. Understanding TWA
Area of Science:
- Cardiology
- Electrophysiology
- Molecular Biology
Background:
- Repolarization alternans are linked to increased susceptibility to ventricular arrhythmias.
- T-wave alternans (TWA) is a potential marker for sudden cardiac death risk.
Purpose of the Study:
- To review the pathophysiology of repolarization alternans.
- To discuss T-wave alternans as a risk stratification marker for malignant ventricular arrhythmias.
Main Methods:
- Literature review of contemporary understanding.
- Analysis of cellular and molecular alterations in diseased hearts.
Main Results:
- T-wave alternans (TWA) shows a strong correlation with ventricular arrhythmia susceptibility and sudden cardiac death.
- Distinct cellular and molecular alterations contribute to repolarization alternans.
Conclusions:
- Repolarization alternans result from diverse cellular/molecular changes leading to repolarization heterogeneity.
- This heterogeneity increases susceptibility to malignant arrhythmias.