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- Title
Microvolt T-Wave Alternans During Atrial and Ventricular Pacing.
- Authors
SHALABY, ALAA A.; VOIGT, ANDREW; EL‐SAED, AIMAN; MAINS, MARTIN; SHUSTERMAN, VLADIMIR
- Abstract
Introduction: Assessment of microvolt T-wave alternans (MTWA) by the spectral analysis (SA) method requires the heart rate to be stable within a certain range. This can be achieved by ventricular pacing (VP). We compared MTWA during short-term VP versus atrial pacing (AP). Methods: Patients presenting for evaluation of risk of sudden cardiac death underwent an invasive electrophysiologic study. The concordance of results of MTWA-VP with MTWA-AP was evaluated, as well as the specificity, sensitivity, negative, and positive predictive values of MTWA-VP versus MTWA-AP. The maximum recorded amplitude of MTWA (MValt) in concordant positive results, as well as noise levels in all, were compared in both pacing modes. Results: We studied 42 consecutive patients, of whom 31 completed both tests (32 by AP, 40 by VP). Compared to AP, VP—MTWA SA had a sensitivity of 93%, specificity of 71%, negative predictive value of 92%, and positive predictive value of 72%. The results were concordant in 25 patients (80%, κ= 0.62, P < 0.001). The noise level was significantly higher during VP than AP (1.4 ± 0.8 vs 1± 0.8, P< 0.01), and there was a trend toward a higher amplitude of TWA by VP (10.7 ± 5.3 vs 7.8 ± 3.9, P = 0.058). Conclusions: MTWA SA is more likely to be completed during VP than AP. Overall there was concordance between both tests. VP generates higher amplitudes and noise, and a higher percentage of nonnegative results.
- Subjects
CARDIAC pacing; CARDIAC arrest; ELECTROPHYSIOLOGY; ARRHYTHMIA treatment; ELECTRIC stimulation
- Publication
Pacing & Clinical Electrophysiology, 2007, Vol 30, pS178
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2007.00633.x