Key result
The time-domain correlation method identified T-wave alternans in 44% (17 of 39) of patients with long QT syndrome, including nonstationary episodes in 8 patients.
Why the study?
Does the time-domain correlation method detect transient T-wave alternans in digital Holter ECG recordings of long QT syndrome patients?
Observational (n=75)
Does the time-domain correlation method detect transient T-wave alternans in digital Holter ECG recordings of long QT syndrome patients?
A novel time-domain correlation method successfully detects both stationary and nonstationary T-wave alternans in digital Holter ECG recordings.
May improve transient TWA detection in LQTS Holter recordings; leaves open prognostic utility pending prospective validation.
Background: Spectral and complex demodulation methods for detection of microvolt T‐wave alternans (TWA) have limited ability to identify transient (nonstationary) TWA episodes. We aimed to develop and test new time‐domain technique allowing TWA detection and quantification in as few as 7 consecutive beats from sinus rhythm ECGs. Methods and results: Quantification of TWA during sinus rhythm required preprocessing consisting of: low‐pass filtering, RR stability testing, baseline and respiratory modulation removal, and T‐wave windowing and synchronization. Our time‐domain correlation method (CM) detects TWA by computing, for each consecutive T wave, an alternans correlation index based on a crosscorrelation technique. CM allows quantitative analysis of the amplitude, duration, and overall magnitude of the TWA episode. The technical performance of CM was confirmed in testing with simulated TWA of varying amplitude, duration, and noisy conditions. The clinical performance of CM was demonstrated by analyzing digital Holter recordings of 39 long QT syndrome patients compared to 36 healthy subjects. CM identified TWA in 17 (44%) patients with nonstationary TWA detected in 8. Conclusion: Our computer algorithms consisting of ECG preprocessing and TWA quantification by the correlation method provides the opportunity to detect nonstationary and stationary TWA in sinus rhythm of digital Holter ECG recordings. A.N.E. 1999;4(4):416–424
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Burattini et al. (1999) conducted an observational in Long QT syndrome (n=75). Time-domain correlation method (CM) vs. Healthy subjects was evaluated on Detection of T-wave alternans (TWA). The time-domain correlation method identified T-wave alternans in 44% (17 of 39) of patients with long QT syndrome, including nonstationary episodes in 8 patients.