Heart Rate–Dependent Hysteresis of T‐Wave Alternans in Primary Prevention ICD Patients

Burattini, Laura; Man, Sumche; Fioretti, Sandro; Nardo, Francesco Di; Swenne, Cees A.

doi:10.1111/anec.12330

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…Moreover, rate-dependent memory which has been shown to contribute to repolarization alternans observed in humans is called hysteresis. This refers to alternans caused by rapid pacing, which persist despite a subsequent slowing of heart rate ( Burattini et al, 2016 ). Due to the slow APD adaptation to BCL change, it may take many seconds for the APD to reach its steady-state value.…”

Section: Mechanisms Of Cardiac Alternans and Arrhythmogenesismentioning

confidence: 99%

Electrophysiological Mechanisms Underlying T-Wave Alternans and Their Role in Arrhythmogenesis

et al. 2021

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T-wave alternans (TWA) reflects every-other-beat alterations in the morphology of the electrocardiogram ST segment or T wave in the setting of a constant heart rate, hence, in the absence of heart rate variability. It is believed to be associated with the dispersion of repolarization and has been used as a non-invasive marker for predicting the risk of malignant cardiac arrhythmias and sudden cardiac death as numerous studies have shown. This review aims to provide up-to-date review on both experimental and simulation studies in elucidating possible mechanisms underlying the genesis of TWA at the cellular level, as well as the genesis of spatially concordant/discordant alternans at the tissue level, and their transition to cardiac arrhythmia. Recent progress and future perspectives in antiarrhythmic therapies associated with TWA are also discussed.

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Section: Mechanisms Of Cardiac Alternans and Arrhythmogenesismentioning

confidence: 99%

Electrophysiological Mechanisms Underlying T-Wave Alternans and Their Role in Arrhythmogenesis

et al. 2021

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“…Microvolt T-wave alternans (TWA), consisting in a subtle alternation of the electrocardiographic (ECG) T wave, is a promising noninvasive indicator of sudden cardiac death [9]. Although low-levels of TWA have been also observed in resting healthy subjects [10,11,12], TWA is more commonly found in patients affected by cardiovascular diseases [11,13,14,15,16] and its amplitude tends to increase with increasing heart rate (HR) [9,17,18]. As a consequence, since HR decrease during sleep and TWA is more hardly detectable, only few studies have investigated TWA incidence during sleep, especially when SA occurs [7,19].…”

Section: Introductionmentioning

confidence: 99%

Overnight T-Wave Alternans in Sleep Apnea Patients

Burattini

Ciotti

D’Ignazio

et al. 2017

Computing in Cardiology Conference (CinC)

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Sleep apnea (SA) is linked to cardiovascular complications and to an increased risk of sudden cardiac death. Microvolt T-wave alternans (TWA) is a noninvasive electrocardiographic (ECG) index of cardiovascular risk; its rate of occurrence in SA patients remains unknown. Thus, this study investigated the occurrence of TWA in SA patients during night. To this aim, overnight ECG recordings of 16 SA patients were analyzed for TWA identification by means of our heart rate adaptive match filter. Results indicate that overnight TWA was characterized by a low mean amplitude (mean TWA: 6±3 µV). However, higher-amplitude transient TWA episodes (max TWA: 29±21 µV) occurred overnight, sometimes when patients were awake (max TWA: 33±18 µV; 56% of cases) and sometimes when patients were sleeping (max TWA: 24±23 µV; 44% of cases with 13%, 19%, 6% and 6% during sleep stage 1, 2, 3 and 4, respectively). In only 3 subjects (19%) TWA peaks occurred during an SA episode: during obstructive apnea with arousal in two cases (max TWA of 7 µV and 17 µV, during stages 1 and 2, respectively) and during hypoapnea with arousal in one case (max TWA of 6 µV while awake). Thus, SA patients show significant transient overnight TWA episodes, not necessarily occurring during a SA episode.

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T-Wave Alternans Identification in Direct and Indirect Fetal Electrocardiography

Burattini

Marcantoni

Nasim

et al. 2020

Innovative Technologies and Signal Processing in Perinatal Medicine

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Heart Rate–Dependent Hysteresis of T‐Wave Alternans in Primary Prevention ICD Patients

Abstract: TWA shows a HR-dependent hysteresis and there is a different behavior of TWA in ICD_Cases and ICD_Controls groups. Consequently, beside exercise TWA also recovery TWA may contribute to identify subjects at increased risk of arrhythmic events.

Cited by 5 publications

References 40 publications

Electrophysiological Mechanisms Underlying T-Wave Alternans and Their Role in Arrhythmogenesis

Electrophysiological Mechanisms Underlying T-Wave Alternans and Their Role in Arrhythmogenesis

Overnight T-Wave Alternans in Sleep Apnea Patients

T-Wave Alternans Identification in Direct and Indirect Fetal Electrocardiography

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