Publication details

Alternativní metody měření mikrovolt alternans T-vlny u pacientů s dysfunkcí levé srdeční komory

Title in English Alternative methods of microvolt T wave alternans measurements in patients with left ventricular cardiac dysfunction
Authors

KŘIVAN Lubomír LOKAJ Petr KOZÁK Milan SEPŠI Milan TRČKA Pavel VLAŠÍNOVÁ Jitka BUREŠOVÁ Lucie ŠPINAR Jindřich

Year of publication 2010
Type Article in Periodical
Magazine / Source Časopis lékařů českých
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords microvolt T wave alternans; bicycle exercise test; atrial pacing; ventricular pacing; malignant arrhythmias
Description The presence of a microvolt T wave alternans (MTWA) is linked with increased risk of malignant arrhythmias and overall mortality. The most common method used for MTWA detection is a bicycle exercise test (BET). Method has still several limitations. Aim. To confirm that comparable MTWA results may be obtained by atrial and ventricular pacing during electrophysiology. To identify an anticipated relation between MTWA and malignant arrhythmia occurrence, or a death. Methods. We obtained MTWA during BET and consequently during atrial and ventricular pacing. All patients underwent a routine electrophysiology testing prior to prophylactic ICD implantation. The results were compared. The occurrence of malignant arrhythmias and death were registered during follow-up. Results. The group consisted of 39 patients. The results of MTWA obtained by BET, atrial and ventricular pacing did not show a significant difference. No difference was found among the three methods in the number of positive leads, and onset heart rate. Ventricular pacing increases the magnitude of MTWA comparing to the remaining two methods. No relation between MTWA results and occurrence of malignant arrhythmias or death was found. Conclusions. Atrial and ventricular pacing lead to comparable MTWA results as BET and may be used as alternative methods in patients where BET is not feasible.

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