Endocardial detection of repolarization alternans

David J. Christini, Kenneth M. Stein, Steven C. Hao, Steven M. Markowitz, Suneet Mittal, David J. Slotwiner, Sei Wai, Mithilesh K. Das, Bruce B. Lerman

Research output: Contribution to journalConference article


Repolarization alternans (RPA) is prognostic of sudden cardiac death and is thought to be mechanistically linked to the initiation of ventricular tachyarrhythmias. We sought to determine whether RPA, which is inherently spatially extended, could be measured using a spatially-localized endocardial lead and, if so, whether RPA could be quantified on a beat-to-beat basis. During diagnostic electrophysiological testing, 21 patients (16M, 5F; 62±16yr) were evaluated for surface T-wave alternans (TWA) and endocardial RPA (via a right ventricular apex unipolar recording) during 5 min of 550 ms right atrial pacing. Power spectral analysis indicated that 7/21 patients had both surface TWA and endocardial RPA, 8/21 patients had neither, and 6/21 patients had discordant results (71% concordance; p=0.04). Importantly, unlike surface TWA alternans, endocardial RPA was detectable on a beat-to-beat basis. Given the putative mechanistic link between RPA and ventricular arrhythmias, beat-to-beat endocardial RPA detection might be of diagnostic or therapeutic utility.

Original languageEnglish (US)
Pages (from-to)1363-1364
Number of pages2
JournalAnnual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
StatePublished - Dec 1 2002
Externally publishedYes
EventProceedings of the 2002 IEEE Engineering in Medicine and Biology 24th Annual Conference and the 2002 Fall Meeting of the Biomedical Engineering Society (BMES / EMBS) - Houston, TX, United States
Duration: Oct 23 2002Oct 26 2002


  • Alternans
  • Nonlinear dynamics
  • Repolarization
  • T-wave
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Signal Processing
  • Biomedical Engineering
  • Computer Vision and Pattern Recognition
  • Health Informatics

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  • Cite this

    Christini, D. J., Stein, K. M., Hao, S. C., Markowitz, S. M., Mittal, S., Slotwiner, D. J., Wai, S., Das, M. K., & Lerman, B. B. (2002). Endocardial detection of repolarization alternans. Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings, 2, 1363-1364.