Key result
T wave alternans during atrial pacing demonstrated a sensitivity of 81.8% and specificity of 74.3% as a predictor of ventricular tachyarrhythmia in patients undergoing electrophysiological study.
Why the study?
Is T-wave alternans during atrial pacing a useful marker for predicting ventricular tachyarrhythmia in patients undergoing electrophysiological study?
Observational (n=100)
Is T-wave alternans during atrial pacing a useful marker for predicting ventricular tachyarrhythmia in patients undergoing electrophysiological study?
Answers are grounded in this paper and cite their sources.
Microvolt T-wave alternans measured during atrial pacing shows high sensitivity and specificity for predicting ventricular tachycardia, with a lower heart rate threshold for onset in VT patients.
1994年にRosembaumらは, 肉眼では判別できないmicrovoltlevelのT波の交互変化 (Twave alternans: 以下TWA) とEPSにおけるVT/Vfの誘発率, および20カ月間の経過観察による心室性頻脈性不整脈の出現とは有意な関連があることを報告した.我々は同様のシステムを使い, 心室頻拍が確認されている症例を対象として, TWAの臨床的有用性を検討した.対象は心室頻拍を有する患者23人を含む100人の患者で, 70～120/分の心房ペーシングによるTWAを測定した.TWA陽性36例, 陰性56例, 判定不能8例, 陽性36例中心室頻拍は18例 (50%) で, TWAはVTの予測因子として感度81.8%, 特異度74.3%であった, VT群ではTWAが出現し始める心拍数, およびその心拍数の目標心拍数に対する割合がVT (-) 群に比し有意に低値であった.
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Tanno et al. (1999) conducted an observational in Patients undergoing electrophysiological study (EPS) (n=100). T wave alternans (TWA) during atrial pacing vs. TWA negative was evaluated on Prediction of ventricular tachyarrhythmia (VT) induced during electrophysiological study (Sensitivity 81.8%, Specificity 74.3%). T wave alternans during atrial pacing demonstrated a sensitivity of 81.8% and specificity of 74.3% as a predictor of ventricular tachyarrhythmia in patients undergoing electrophysiological study.
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