Time‐Domain T‐Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome

Abstract

Elevated time-domain TWA on AECG confirms arrhythmia risk in symptomatic BrS patients without the need for provocative stimuli.

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

“…There were no differences in the max-TWA values for 4L-V1, 4L-V2, 3L-V1, and 4L-V5 among the 4 groups. The discrepancy of the results from the previous report [20] may be related to the number of the patients and a regional specificity of TWA [22]. Morita et al demonstrated that phase 2 reentry and TWA were more likely to originate from RVOT epicardium than from the RVOT endocardium or the RV inferoanterior site in tissue models of Brugada syndrome.…”

“…In the present study, we focused on the MMA analysis of TWA using 24-M-ECG, without conducting stress tests. On the other hand, Uchimura et al [20] showed that max-TWA at the standard lead position (4L-V2) during the entire day was useful for risk stratification of VF episodes. We investigated the max-TWA values in more patients in detail.…”

J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge

“…Other markers associated with increased risk but with limited or inconsistent data include: a) late potentials recorded using signal-averaged electrocardiography; 283-285 b) microscopic T-wave alternans (TWA); 286 c) macroscopic TWA during a sodium-blocker challenge test; 285, 287, 288 d) increased QRS width; 49, 248, 277, 289, 290 e) prominent R wave in aVR; 289-291 and f) augmented ST-segment elevation of a Type 1 Brugada pattern during the recovery phase of an exercise test. 292 Prolonged Tpeak-Tend 293-296 and relatively steep QT/RR slope have been associated with higher risk in cases of BrS.…”

Late gadolinium enhancement of cardiac magnetic resonance imaging indicates abnormalities of time-domain T-wave alternans in hypertrophic cardiomyopathy with ventricular tachycardia

“…11 Time-domain TWA is also applied to various diseases such as heart failure, vasospastic angina, and Brugada syndrome and is shown to be a good predictive marker. [12][13][14] In contrast, it has been shown that scar tissue can be detected as late gadolinium enhancement (LGE) on contrastenhanced cardiac magnetic resonance (CMR) imaging even in nonischemic myocardial disease such as HCM [15][16][17][18] and that the degree of LGE is a predictive factor of cardiac sudden death. 15,16,18 Moreover, the presence of myocardial scar detected by LGE has been described as a good independent predictor of all-cause and cardiac mortality in patients with HCM.…”