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 Das, Bruce B. Lerman

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

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)
Title of host publicationAnnual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings
Pages1363-1364
Number of pages2
Volume2
StatePublished - 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

Other

OtherProceedings of the 2002 IEEE Engineering in Medicine and Biology 24th Annual Conference and the 2002 Fall Meeting of the Biomedical Engineering Society (BMES / EMBS)
CountryUnited States
CityHouston, TX
Period10/23/0210/26/02

Fingerprint

Spectrum analysis
Lead
Testing

Keywords

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

ASJC Scopus subject areas

  • Bioengineering

Cite this

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

Endocardial detection of repolarization alternans. / Christini, David J.; Stein, Kenneth M.; Hao, Steven C.; Markowitz, Steven M.; Mittal, Suneet; Slotwiner, David J.; Wai, Sei; Das, Mithilesh; Lerman, Bruce B.

Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2 2002. p. 1363-1364.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Christini, DJ, Stein, KM, Hao, SC, Markowitz, SM, Mittal, S, Slotwiner, DJ, Wai, S, Das, M & Lerman, BB 2002, Endocardial detection of repolarization alternans. in Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. vol. 2, pp. 1363-1364, Proceedings 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, 10/23/02.
Christini DJ, Stein KM, Hao SC, Markowitz SM, Mittal S, Slotwiner DJ et al. Endocardial detection of repolarization alternans. In Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2. 2002. p. 1363-1364
Christini, David J. ; Stein, Kenneth M. ; Hao, Steven C. ; Markowitz, Steven M. ; Mittal, Suneet ; Slotwiner, David J. ; Wai, Sei ; Das, Mithilesh ; Lerman, Bruce B. / Endocardial detection of repolarization alternans. Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. Vol. 2 2002. pp. 1363-1364
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