Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias

N. A Mark Estes, Greg Michaud, Douglas P. Zipes, Nabil El-Sherif, Ferdinand J. Venditti, David S. Rosenbaum, Paul Albrecht, Paul J. Wang, Richard J. Cohen

Research output: Contribution to journalArticle

121 Citations (Scopus)

Abstract

This investigation was performed to evaluate the feasibility of detecting repolarization alternans with the heart rate elevated with a bicycle exercise protocol. Sensitive spectral signal-processing techniques are able to detect beat-to-beat alternation of the amplitude of the T wave, which is not visible on standard electrocardiogram. Previous animal and human investigations using atrial or ventricular pacing have demonstrated that T- wave alternans is a marker of vulnerability to ventricular arrhythmias. Using a spectral analysis technique incorporating noise reduction signal-processing software, we evaluated electrical alternans at rest and with the heart rate elevated during a bicycle exercise protocol. In this study we defined optimal criteria for electrical alternans to separate patients from those without inducible arrhythmias. Alternans and signal-averaged electrocardiographic results were compared with the results of vulnerability to ventricular arrhythmias as defined by induction of sustained ventricular tachycardia or fibrillation at electrophysiologic evaluation. In 27 patients alternans recorded at rest and with exercise had a sensitivity of 89%, specificity of 75%, and overall clinical accuracy of 80% (p

Original languageEnglish (US)
Pages (from-to)1314-1318
Number of pages5
JournalThe American Journal of Cardiology
Volume80
Issue number10
DOIs
StatePublished - Nov 15 1997
Externally publishedYes

Fingerprint

Cardiac Arrhythmias
Exercise
Heart Rate
Ventricular Fibrillation
Ventricular Tachycardia
Noise
Electrocardiography
Software
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Estes, N. A. M., Michaud, G., Zipes, D. P., El-Sherif, N., Venditti, F. J., Rosenbaum, D. S., ... Cohen, R. J. (1997). Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. The American Journal of Cardiology, 80(10), 1314-1318. https://doi.org/10.1016/S0002-9149(97)00694-2

Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. / Estes, N. A Mark; Michaud, Greg; Zipes, Douglas P.; El-Sherif, Nabil; Venditti, Ferdinand J.; Rosenbaum, David S.; Albrecht, Paul; Wang, Paul J.; Cohen, Richard J.

In: The American Journal of Cardiology, Vol. 80, No. 10, 15.11.1997, p. 1314-1318.

Research output: Contribution to journalArticle

Estes, NAM, Michaud, G, Zipes, DP, El-Sherif, N, Venditti, FJ, Rosenbaum, DS, Albrecht, P, Wang, PJ & Cohen, RJ 1997, 'Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias', The American Journal of Cardiology, vol. 80, no. 10, pp. 1314-1318. https://doi.org/10.1016/S0002-9149(97)00694-2
Estes, N. A Mark ; Michaud, Greg ; Zipes, Douglas P. ; El-Sherif, Nabil ; Venditti, Ferdinand J. ; Rosenbaum, David S. ; Albrecht, Paul ; Wang, Paul J. ; Cohen, Richard J. / Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. In: The American Journal of Cardiology. 1997 ; Vol. 80, No. 10. pp. 1314-1318.
@article{5a66e7e2c42142009f3cc3a6e2ce7be6,
title = "Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias",
abstract = "This investigation was performed to evaluate the feasibility of detecting repolarization alternans with the heart rate elevated with a bicycle exercise protocol. Sensitive spectral signal-processing techniques are able to detect beat-to-beat alternation of the amplitude of the T wave, which is not visible on standard electrocardiogram. Previous animal and human investigations using atrial or ventricular pacing have demonstrated that T- wave alternans is a marker of vulnerability to ventricular arrhythmias. Using a spectral analysis technique incorporating noise reduction signal-processing software, we evaluated electrical alternans at rest and with the heart rate elevated during a bicycle exercise protocol. In this study we defined optimal criteria for electrical alternans to separate patients from those without inducible arrhythmias. Alternans and signal-averaged electrocardiographic results were compared with the results of vulnerability to ventricular arrhythmias as defined by induction of sustained ventricular tachycardia or fibrillation at electrophysiologic evaluation. In 27 patients alternans recorded at rest and with exercise had a sensitivity of 89{\%}, specificity of 75{\%}, and overall clinical accuracy of 80{\%} (p",
author = "Estes, {N. A Mark} and Greg Michaud and Zipes, {Douglas P.} and Nabil El-Sherif and Venditti, {Ferdinand J.} and Rosenbaum, {David S.} and Paul Albrecht and Wang, {Paul J.} and Cohen, {Richard J.}",
year = "1997",
month = "11",
day = "15",
doi = "10.1016/S0002-9149(97)00694-2",
language = "English (US)",
volume = "80",
pages = "1314--1318",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias

AU - Estes, N. A Mark

AU - Michaud, Greg

AU - Zipes, Douglas P.

AU - El-Sherif, Nabil

AU - Venditti, Ferdinand J.

AU - Rosenbaum, David S.

AU - Albrecht, Paul

AU - Wang, Paul J.

AU - Cohen, Richard J.

PY - 1997/11/15

Y1 - 1997/11/15

N2 - This investigation was performed to evaluate the feasibility of detecting repolarization alternans with the heart rate elevated with a bicycle exercise protocol. Sensitive spectral signal-processing techniques are able to detect beat-to-beat alternation of the amplitude of the T wave, which is not visible on standard electrocardiogram. Previous animal and human investigations using atrial or ventricular pacing have demonstrated that T- wave alternans is a marker of vulnerability to ventricular arrhythmias. Using a spectral analysis technique incorporating noise reduction signal-processing software, we evaluated electrical alternans at rest and with the heart rate elevated during a bicycle exercise protocol. In this study we defined optimal criteria for electrical alternans to separate patients from those without inducible arrhythmias. Alternans and signal-averaged electrocardiographic results were compared with the results of vulnerability to ventricular arrhythmias as defined by induction of sustained ventricular tachycardia or fibrillation at electrophysiologic evaluation. In 27 patients alternans recorded at rest and with exercise had a sensitivity of 89%, specificity of 75%, and overall clinical accuracy of 80% (p

AB - This investigation was performed to evaluate the feasibility of detecting repolarization alternans with the heart rate elevated with a bicycle exercise protocol. Sensitive spectral signal-processing techniques are able to detect beat-to-beat alternation of the amplitude of the T wave, which is not visible on standard electrocardiogram. Previous animal and human investigations using atrial or ventricular pacing have demonstrated that T- wave alternans is a marker of vulnerability to ventricular arrhythmias. Using a spectral analysis technique incorporating noise reduction signal-processing software, we evaluated electrical alternans at rest and with the heart rate elevated during a bicycle exercise protocol. In this study we defined optimal criteria for electrical alternans to separate patients from those without inducible arrhythmias. Alternans and signal-averaged electrocardiographic results were compared with the results of vulnerability to ventricular arrhythmias as defined by induction of sustained ventricular tachycardia or fibrillation at electrophysiologic evaluation. In 27 patients alternans recorded at rest and with exercise had a sensitivity of 89%, specificity of 75%, and overall clinical accuracy of 80% (p

UR - http://www.scopus.com/inward/record.url?scp=0030778791&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030778791&partnerID=8YFLogxK

U2 - 10.1016/S0002-9149(97)00694-2

DO - 10.1016/S0002-9149(97)00694-2

M3 - Article

VL - 80

SP - 1314

EP - 1318

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 10

ER -