eMedicine Specialties > Cardiology > Arrhythmias
Electrical Alternans: Follow-up
Updated: Aug 26, 2008
Follow-up
Complications
No known complications of electrical alternans exist. All complications are due to the underlying disease process.
Prognosis
The finding of electrical alternans does not change the prognosis of the underlying disease process.
Miscellaneous
Medicolegal Pitfalls
- Failure to recognize electrical alternans on ECG, resulting in detrimental progression of the underlying disease process
- Delay of emergent pericardiocentesis for correction of cardiac tamponade due to failure of recognition of electrical alternans
More on Electrical Alternans |
| Overview: Electrical Alternans |
| Differential Diagnoses & Workup: Electrical Alternans |
| Treatment & Medication: Electrical Alternans |
Follow-up: Electrical Alternans |
| Multimedia: Electrical Alternans |
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References
Cruz Filho FE, Maia IG, Fagundes ML, et al. Electrical behavior of T-wave polarity alternans in patients with congenital long QT syndrome. J Am Coll Cardiol. Jul 2000;36(1):167-73. [Medline].
Bardaji A, Vidal F, Richart C. T wave alternans associated with amiodarone. J Electrocardiol. Apr 1993;26(2):155-7. [Medline].
Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation. Mar 16 1999;99(10):1385-94. [Medline].
Nakamura Y, Kaseno K, Kubo T. Transient ST-segment elevation in subarachnoid hemorrhage. J Electrocardiol. Apr 1989;22(2):133-7. [Medline].
Alexander ME, Cecchin F, Huang KP, Berul CI. Microvolt t-wave alternans with exercise in pediatrics and congenital heart disease: limitations and predictive value. Pacing Clin Electrophysiol. Jul 2006;29(7):733-41. [Medline].
Paz O, Zhou X, Gillberg J, Tseng HJ, Gang E, Swerdlow C. Detection of T-wave alternans using an implantable cardioverter-defibrillator. Heart Rhythm. Jul 2006;3(7):791-7. [Medline].
Brembilla-Perrot B, Lucron H, Schwalm F, Haouzi A. Mechanism of QRS electrical alternans. Heart. Feb 1997;77(2):180-2. [Medline].
Choi BR, Jang W, Salama G. Spatially discordant voltage alternans cause wavebreaks in ventricular fibrillation. Heart Rhythm. Aug 2007;4(8):1057-68. [Medline].
Chou T, Knitans T. Electrical alternans. In: Electrocardiography in Clinical Practice. 4th ed. 1996:248-56.
Donato A, Oreto G, Schamroth L. P wave alternans. Am Heart J. Sep 1988;116(3):875-7. [Medline].
Gaffney FA, Keller AM, Peshock RM, et al. Pathophysiologic mechanisms of cardiac tamponade and pulsus alternans shown by echocardiography. Am J Cardiol. Jun 1 1984;53(11):1662-6. [Medline].
Gold MR, Bloomfield DM, Anderson KP, et al. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol. Dec 2000;36(7):2247-53. [Medline].
Hearing H. Experimentelle Studien an Saugentieren uber das Electrocardiogram. Z Exper Med. 1909;7:363.
Hellerstein HK, Liebow IM. Electrical alternation in experimental coronary artery occlusion. Am J Physiol. Feb 1950;160(2):366-74. [Medline].
Hua F, Johns DC, Gilmour RF. Suppression of electrical alternans by overexpression of HERG in canine ventricular myocytes. Am J Physiol Heart Circ Physiol. Jun 2004;286(6):H2342-51. [Medline].
Kalter HH, Schwartz ML. Electrical alternans. NY State J Med. 1948;1:1164-66.
Kop WJ, Krantz DS, Nearing BD, et al. Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls. Circulation. Apr 20 2004;109(15):1864-9. [Medline].
Lewis T. Notes upon alternation of the heart. Q J Med. 1910;4:141-4.
Murda'h MA, McKenna WJ, Camm AJ. Repolarization alternans: techniques, mechanisms, and cardiac vulnerability. Pacing Clin Electrophysiol. Oct 1997;20(10 Pt 2):2641-57. [Medline].
Nearing BD, Verrier RL. Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy. J Appl Physiol. Feb 2002;92(2):541-9. [Medline].
Puletti M, Curione M, Righetti G, Jacobellis G. Alternans of the ST segment and T wave in acute myocardial infarction. J Electrocardiol. 1980;13(3):297-300. [Medline].
Ring ME, Fenster PE. Exercise-induced ST segment alternans. Am Heart J. May 1986;111(5):1009-11. [Medline].
Rosenbaum DS, Jackson LE, Smith JM, et al. Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med. Jan 27 1994;330(4):235-41. [Medline].
Saito S, Watanabe I, Hibiya K, et al. Intracoronary ST-segment alternans during coronary balloon angioplasty. Jpn Heart J. Mar 1998;39(2):221-4. [Medline].
Schwartz PJ, Malliani A. Electrical alternation of the T-wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome. Am Heart J. Jan 1975;89(1):45-50. [Medline].
Shimoni Z, Flatau E, Schiller D, et al. Electrical alternans of giant U waves with multiple electrolyte deficits. Am J Cardiol. Oct 1 1984;54(7):920-1. [Medline].
Slattery DE, Dickerson DW, Pollack CV Jr. Subtle electrical alternans in a large pericardial effusion with tamponade. J Emerg Med. May-Jun 1997;15(3):371-2. [Medline].
Smith JM, Clancy EA, Valeri CR, et al. Electrical alternans and cardiac electrical instability. Circulation. Jan 1988;77(1):110-21. [Medline].
Surawicz B. Electrophysiologic substrate of torsade de pointes: dispersion of repolarization or early after depolarizations?. J Am Coll Cardiol. Jul 1989;14(1):172-84. [Medline].
Surawicz B, Fisch C. Cardiac alternans: diverse mechanisms and clinical manifestations. J Am Coll Cardiol. Aug 1992;20(2):483-99. [Medline].
Verrier RL, Nearing BD, Kwaku KF. Noninvasive sudden death risk stratification by ambulatory ECG-based T-wave alternans analysis: evidence and methodological guidelines. Ann Noninvasive Electrocardiol. Jan 2005;10(1):110-20. [Medline].
Zareba W, Moss AJ, le Cessie S, Hall WJ. T wave alternans in idiopathic long QT syndrome. J Am Coll Cardiol. Jun 1994;23(7):1541-6. [Medline].
Further Reading
Keywords
mechanical alternans, pulsus alternans, repolarization alternans, conduction and refractoriness alternans, alternans due to cardiac motion, repolarization or conduction abnormality of the Purkinje fibers or myocardium, vasospastic angina pectoris, acute myocardial infarction, nonvasospastic angina pectoris, congenital long QT syndrome, hypocalcemia, hypokalemia, hypomagnesemia, hypertrophic cardiomyopathy, alcoholic cardiomyopathy, congestive heart failure, acute pulmonary embolism, cardiac resuscitation, myocardial ischemia, atrial fibrillation, Wolff-Parkinson-White syndrome, rheumatic heart disease, acute pulmonary embolism, myocardial contusion, left ventricular dysfunction, large pericardial effusion, hypertrophic cardiomyopathy
Follow-up: Electrical Alternans