Microvolt T‐Wave Alternans during Holter Monitoring in Children and Adolescents

Макаров, Л. М.; Комолятова, В. Н.

doi:10.1111/j.1542-474x.2010.00354.x

Cited by 21 publications

(16 citation statements)

References 23 publications

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“…1, are defined as the beat-to-beat alternation in the action potential duration (APD). Multiple studies have shown that alternans act as a precursor to these life-threatening arrhythmias, since it can transition into VF under rapid pacing rates [3][4][5][6]. On an electrocardiogram (ECG), these alternans appear as alternations in the T -wave segments.…”

Section: Introductionmentioning

confidence: 99%

Control of cardiac alternans by mechanical and electrical feedback

et al. 2014

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A persistent alternation in the cardiac action potential duration has been linked to the onset of ventricular arrhythmia, which may lead to sudden cardiac death. A coupling between these cardiac alternans and the intracellular calcium dynamics has also been identified in previous studies. In this paper, the system of PDEs describing the small amplitude of alternans and the alternation of peak intracellular Ca(2+) are stabilized by optimal boundary and spatially distributed actuation. A simulation study demonstrating the successful annihilation of both alternans on a one-dimensional cable of cardiac cells by utilizing the full-state feedback controller is presented. Complimentary to these studies, a three variable Nash-Panfilov model is used to investigate alternans annihilation via mechanical (or stretch) perturbations. The coupled model includes the active stress which defines the mechanical properties of the tissue and is utilized in the feedback algorithm as an independent input from the pacing based controller realization in alternans annihilation. Simulation studies of both control methods demonstrate that the proposed methods can successfully annihilate alternans in cables that are significantly longer than 1 cm, thus overcoming the limitations of earlier control efforts.

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Section: Introductionmentioning

confidence: 99%

Control of cardiac alternans by mechanical and electrical feedback

et al. 2014

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“…In children with congenital and/or acquired heart diseases, there were only two studies using the time-domain Modifi ed Moving Average method microwolt T-wave alternans. In this study, Makarov et al compared 63 healthy children with 85 pediatric patients with congenital or acquired cardiovascular disease and microwolt T-wave alternans values were found signifi cantly higher in patient group (24). In another study, Makarov et al were evaluated 20 healthy newborns on fi rst, second and fourth days after birth with the same technique, and the average peak value of T-wave alternans was found to be 32±8 (12-55) μV (25).…”

Section: Discussionmentioning

confidence: 82%

Therapeutic hypothermia and myocardium in perinatal asphyxia: a microvolt T-wave alternans and Doppler echocardiography study

Karpuz¹,

Çelik²,

Giray³

et al. 2018

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OBJECTIVES: This is the fi rst study evaluating the predictive value of myocardial performance on arrhythmia and mortality via tissue-Doppler and microvolt T-wave alternans in infants with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia-rewarming. METHODS: The study included 23 term newborns having criteria for hypoxic-ischemic encephalopathy, and 12 controls. Tissue-Doppler imaging and T-wave alternans were performed in the fi rst six hours after birth in patients from both groups and after hypothermia-rewarming treatment on the fi fth day. RESULTS: The basal T-wave alternans values were higher in patients in lead aVF(p < 0.001) which also correlated with existing acidemia (r = 0.517; p = 0.012). Basal T-wave alternans and post-treatment values of patients were compared in leads V1 (p < 0.001) and aVF (p < 0.001); a signifi cant decrease was found on the fi fth day. Moreover, right ventricle diastolic diameter and estimated systolic pulmonary artery pressure of patients in the fi rst 6 hours were higher (p = 0.03, p < 0.001, respectively). Although, the ejection fraction of patients did not decrease, basal values of left and right ventricular systolic and diastolic functions were lower initially, and increased signifi cantly after treatment. CONCLUSION: The global cardiac functions and myocardial performance of newborns with hypoxic-ischemia might be improved with therapeutic hypothermia which can be determined by using T-wave alternans and tissueDoppler measurements. However, further studies are needed to assess whether these measurements are prognostic in determining the myocardial dysfunction and arrhythmias (Tab. 2, Fig. 3, Ref. 26). Text in PDF www.elis.sk.

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“…22 In our study, we used MMA method to evaluate MTWA in 24-hour Holter ECG like in the study by Makarov and Komoliatova. In 94% healthy children, values of TWA do not exceed 55 µV but 20-50% children with cardiac pathology had TWA more than 55 µV.…”

Section: Discussionmentioning

confidence: 99%