Vol 15, No 3 (2008)
How to do
Published online: 2008-04-14
How to do exercise-induced T-wave alternans testing using the spectral method
Cardiol J 2008;15(3):288-292.
Abstract
The present review summarizes current aspects on how to perform noninvasive microvolt
T-wave alternans (mTWA) testing in clinical practice. The focus is on methodologic issues
such as patient-related, or technical aspects, and interpretation of the results. Special attention
is given to the different sources of noise that may interfere with mTWA assessment. The role of
beta-blocker therapy and its potential effect on mTWA is discussed as well. In the first clinical
studies of mTWA, a high rate of indeterminate test results was observed. In this respect,
patient-related indeterminacy has been demonstrated to be associated with an increased mortality
and such tests are thus regarded as “abnormal” whereas technically inadequate tests are
classified as indeterminate. Since mTWA evolves over time in patients with structural heart
disease, the “optimal timing” for mTWA assessment is rather in the chronic phase than in the
acute setting of heart disease. (Cardiol J 2008; 15: 288-292)
Keywords: arrhythmia risk stratificationmicrovolt T-wave alternansmethodology