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Related Experiment Videos

Endocardial detection of repolarization alternans.

David J Christini1, Kenneth M Stein, Steven C Hao

  • 1Department of Medicine, Division of Cardiology, Weill Medical College of Cornell University, New York, NY 10021, USA. dchristi@med.cornell.edu

IEEE Transactions on Bio-Medical Engineering
|July 10, 2003
PubMed
Summary

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Repolarization alternans (RPA), a marker for sudden cardiac death, can be detected using a single heart lead. This endocardial RPA measurement offers beat-to-beat detection, unlike surface electrocardiograms.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Repolarization alternans (RPA) predicts sudden cardiac death and ventricular arrhythmias.
  • Current detection methods rely on surface electrocardiograms, limiting therapeutic applications.

Purpose of the Study:

  • To investigate the feasibility of measuring endocardial RPA using a single right-ventricular lead in humans.
  • To assess the potential for implantable device detection of RPA.

Main Methods:

  • Twenty-eight patients underwent electrophysiological testing with right-atrial pacing.
  • Simultaneous measurement of surface T-wave alternans (TWA) and endocardial RPA.
  • Power spectral analysis was used for data evaluation.

Main Results:

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  • Endocardial RPA detection showed 71% concordance with surface TWA (p = 0.02).
  • Unlike surface TWA, endocardial RPA was detectable on a beat-to-beat basis.
  • 8/28 patients had discordant results, suggesting potential for novel detection.

Conclusions:

  • A single right-ventricular endocardial lead can measure RPA in humans.
  • Beat-to-beat endocardial RPA detection may offer diagnostic and therapeutic advantages for arrhythmias.
  • This approach could enable implantable device-based RPA monitoring.