Electrical alternans in wide complex tachycardias

Mark S. Kremers, John Miller, Mark E. Josephson

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

The occurrence of electrical alternation of 0.1 mV or greater of the QRS or T wave was analyzed in 156 electrocardiograms that showed wide QRS complex tachycardias from 91 patients. One hundred thirty-six ventricular tachycardias (VT) were recorded from 74 patients and 20 supraventricular tachycardias (SVT) from 17 patients. Alternans was present in 42 tracings (27%) from 35 patients (38%) and was equally frequent in the patients with VT (39%) and those with SVT (35%). Alternans occurred in 36 VTs (27%) and 6 SVTs (30%). Tachycardias with alternans had a shorter mean cycle length than tachycardians without alternans (339 ± 53 vs 368 ± 85 ms, p <0.05), but were not associated with a particular QRS morphology or axis. Alternans was most frequent in leads V2 and V3 and was seen in more leads during SVT than VT (7.2 ± 2.6 vs 3.7 ± 2.5, p <0.005). All SVTs with alternans incorporated an atrioventricular bypass tract. Electrical alternans occurs frequently in wide QRS tachycardias. Alone, it does not help differentiate VT from SVT. SVTs utilizing bypass tracts frequently show alternans even if the QRS is wide, and this finding may be useful in determining the mechanism of SVTs with aberrant intraventricular conduction.

Original languageEnglish (US)
Pages (from-to)305-308
Number of pages4
JournalThe American Journal of Cardiology
Volume56
Issue number4
DOIs
StatePublished - Aug 1 1985
Externally publishedYes

Fingerprint

Tachycardia
Supraventricular Tachycardia
Ventricular Tachycardia
Electrocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Electrical alternans in wide complex tachycardias. / Kremers, Mark S.; Miller, John; Josephson, Mark E.

In: The American Journal of Cardiology, Vol. 56, No. 4, 01.08.1985, p. 305-308.

Research output: Contribution to journalArticle

Kremers, Mark S. ; Miller, John ; Josephson, Mark E. / Electrical alternans in wide complex tachycardias. In: The American Journal of Cardiology. 1985 ; Vol. 56, No. 4. pp. 305-308.
@article{9e968795b5294c4597dffca5898ac8b4,
title = "Electrical alternans in wide complex tachycardias",
abstract = "The occurrence of electrical alternation of 0.1 mV or greater of the QRS or T wave was analyzed in 156 electrocardiograms that showed wide QRS complex tachycardias from 91 patients. One hundred thirty-six ventricular tachycardias (VT) were recorded from 74 patients and 20 supraventricular tachycardias (SVT) from 17 patients. Alternans was present in 42 tracings (27{\%}) from 35 patients (38{\%}) and was equally frequent in the patients with VT (39{\%}) and those with SVT (35{\%}). Alternans occurred in 36 VTs (27{\%}) and 6 SVTs (30{\%}). Tachycardias with alternans had a shorter mean cycle length than tachycardians without alternans (339 ± 53 vs 368 ± 85 ms, p <0.05), but were not associated with a particular QRS morphology or axis. Alternans was most frequent in leads V2 and V3 and was seen in more leads during SVT than VT (7.2 ± 2.6 vs 3.7 ± 2.5, p <0.005). All SVTs with alternans incorporated an atrioventricular bypass tract. Electrical alternans occurs frequently in wide QRS tachycardias. Alone, it does not help differentiate VT from SVT. SVTs utilizing bypass tracts frequently show alternans even if the QRS is wide, and this finding may be useful in determining the mechanism of SVTs with aberrant intraventricular conduction.",
author = "Kremers, {Mark S.} and John Miller and Josephson, {Mark E.}",
year = "1985",
month = "8",
day = "1",
doi = "10.1016/0002-9149(85)90854-9",
language = "English (US)",
volume = "56",
pages = "305--308",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Electrical alternans in wide complex tachycardias

AU - Kremers, Mark S.

AU - Miller, John

AU - Josephson, Mark E.

PY - 1985/8/1

Y1 - 1985/8/1

N2 - The occurrence of electrical alternation of 0.1 mV or greater of the QRS or T wave was analyzed in 156 electrocardiograms that showed wide QRS complex tachycardias from 91 patients. One hundred thirty-six ventricular tachycardias (VT) were recorded from 74 patients and 20 supraventricular tachycardias (SVT) from 17 patients. Alternans was present in 42 tracings (27%) from 35 patients (38%) and was equally frequent in the patients with VT (39%) and those with SVT (35%). Alternans occurred in 36 VTs (27%) and 6 SVTs (30%). Tachycardias with alternans had a shorter mean cycle length than tachycardians without alternans (339 ± 53 vs 368 ± 85 ms, p <0.05), but were not associated with a particular QRS morphology or axis. Alternans was most frequent in leads V2 and V3 and was seen in more leads during SVT than VT (7.2 ± 2.6 vs 3.7 ± 2.5, p <0.005). All SVTs with alternans incorporated an atrioventricular bypass tract. Electrical alternans occurs frequently in wide QRS tachycardias. Alone, it does not help differentiate VT from SVT. SVTs utilizing bypass tracts frequently show alternans even if the QRS is wide, and this finding may be useful in determining the mechanism of SVTs with aberrant intraventricular conduction.

AB - The occurrence of electrical alternation of 0.1 mV or greater of the QRS or T wave was analyzed in 156 electrocardiograms that showed wide QRS complex tachycardias from 91 patients. One hundred thirty-six ventricular tachycardias (VT) were recorded from 74 patients and 20 supraventricular tachycardias (SVT) from 17 patients. Alternans was present in 42 tracings (27%) from 35 patients (38%) and was equally frequent in the patients with VT (39%) and those with SVT (35%). Alternans occurred in 36 VTs (27%) and 6 SVTs (30%). Tachycardias with alternans had a shorter mean cycle length than tachycardians without alternans (339 ± 53 vs 368 ± 85 ms, p <0.05), but were not associated with a particular QRS morphology or axis. Alternans was most frequent in leads V2 and V3 and was seen in more leads during SVT than VT (7.2 ± 2.6 vs 3.7 ± 2.5, p <0.005). All SVTs with alternans incorporated an atrioventricular bypass tract. Electrical alternans occurs frequently in wide QRS tachycardias. Alone, it does not help differentiate VT from SVT. SVTs utilizing bypass tracts frequently show alternans even if the QRS is wide, and this finding may be useful in determining the mechanism of SVTs with aberrant intraventricular conduction.

UR - http://www.scopus.com/inward/record.url?scp=0021810079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021810079&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(85)90854-9

DO - 10.1016/0002-9149(85)90854-9

M3 - Article

VL - 56

SP - 305

EP - 308

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 4

ER -