Related Experiment Video

Updated: Jun 25, 2026

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
04:48

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

T-wave variability as a risk stratifier in patients with dilated cardiomyopathy

Jerneja Tasic1, Igor Zupan

  • 1Department of Cardiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia. jernejatasic@gmail.com

Pacing and Clinical Electrophysiology : PACE
|March 3, 2009
PubMed

Insights

Resting T-wave variability (TVAR) can predict sudden cardiac death (SCD) risk in patients with reduced ejection fraction. Maximum TVAR values identified patients at higher risk, offering a potential non-stress testing diagnostic tool.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • T-wave alternans (TWA) is a known risk marker for sudden cardiac death (SCD).
  • Traditional TWA assessment requires stress testing, limiting its routine clinical application.
  • This study explored T-wave amplitude variability (TVAR) at rest as an alternative SCD risk stratification method.

Purpose of the Study:

  • To evaluate the utility of resting TVAR in identifying patients at risk of SCD.
  • To determine if TVAR can serve as a non-invasive predictor of arrhythmic events.

Main Methods:

  • A cohort of 57 patients with reduced ejection fraction (≤40%) was studied.
  • High-resolution electrocardiographic recordings were obtained during supine rest for TVAR assessment.
  • The vector magnitude was utilized as the primary lead for TVAR analysis.

Main Results:

  • Maximum TVAR values were significantly lower in patients who received an implantable cardioverter-defibrillator (ICD) post-SCD (67 μV) compared to those without ICD history (95 μV; P=0.045).
  • Multivariate analysis confirmed maximum TVAR as an independent predictor of SCD risk.
  • Mean and median TVAR values did not differ significantly between groups.

Conclusions:

  • Maximum TVAR measured at rest is a significant predictor of arrhythmic events in patients with dilated cardiomyopathy.
  • Resting TVAR assessment offers a promising, non-invasive approach for SCD risk stratification.
Abstract

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...