title: [T-wave alternation: a new method for identifying patients at risk of malignant ventricular tachyarrhythmia].
abstract: T wave alternans (TWA) is a change, in the microvolt range, of T wave amplitude on ABABAB sequence. TWA depends on heart rate, being optimally analyzed at a target frequency of 110 b/min. Initial studies used atrial pacing to reach the target frequency and reported a sensitivity and specificity of 89% for TWA in predicting tachyarrhythmic events. Subsequently, similar results were obtained using ergometric test to reach the target frequency, a less invasive and more "physiologic" approach to increase heart rate. This method became therefore the elective system to increase heart rate in order to evaluate the presence of TWA by means of spectral analysis. At present, various groups of high arrhythmic risk patients have been evaluated, including those with a recent myocardial infarction, congestive heart failure, implantable cardiac defibrillator and clinical indication to programmed ventricular stimulation. In all clinical conditions analyzed, TWA analysis demonstrated a good diagnostic accuracy, suggesting a possible clinical use of the test in these settings.
authors.affiliation: Divisione di Cardiologia, Fondazione S. Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Istituto Scientifico, Via Roncaccia, 16 21049 Tradate, VA. rpedretti@fsm.it
authors.forename: Roberto F E
authors.initials: RF
authors.lastname: Pedretti
authors.forename: Simona
authors.initials: S
authors.lastname: Sarzi Braga
authors.forename: Antonio
authors.initials: A
authors.lastname: Laporta
authors.forename: Raffaella
authors.initials: R
authors.lastname: Vaninetti
authors.forename: Anna
authors.initials: A
authors.lastname: Picozzi
authors.forename: Gaia
authors.initials: G
authors.lastname: Cattadori
authors.forename: Daniele
authors.initials: D
authors.lastname: Marangoni
mesh_terms: D004562:Electrocardiography; D004594:Electrophysiology; D005080:Exercise Test; D006333:Heart Failure / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000503:physiopathology*
vernacular_title: L'alternanza dell'onda T: un nuovo metodo per individuare i pazienti a rischio di tachiaritmie ventricolari maligne.