Optimizing Ambulatory ECG Monitoring of T-Wave Alternans for Arrhythmia Risk Assessment
详细信息 查看全文
文摘
Considerable scientific data support the potential value of T-wave alternans (TWA) as anindex of vulnerability to ventricular fibrillation. This chapter summarizes our state of knowledge regardingthe use of routine ambulatory ECGs to evaluate TWA and discusses recent methodologic approaches designed tooptimize AECG-based TWA analysis for arrhythmia risk stratification. Newer methods, including the nonspectraltechnique of Modified Moving Average analysis, appear promising in detecting TWA during the changingconditions associated with daily activities. The Modified Moving Average approach does not requirespecialized electrodes and is not encumbered by the need to achieve target heart rates, as is the case forconventional spectral-based methods. Guidelines are provided for evaluating latent cardiac electricalinstability using AECG-based TWA testing. These recent developments make possible the TWA analysis ofambulatory ECGs not only in prospective trials but also in vast stores of archival data.