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Electrical alternans

MedGen UID:
215131
•Concept ID:
C1142551
•
Finding
Synonyms: Electrical Alternans; Electrical Alternans by ECG Finding; Electrical Alternans by EKG Finding; Electrical alternation of heart
SNOMED CT: Electrical alternation of heart (423863005); Electrical alternans (423863005)
 
HPO: HP:0025078

Definition

The QRS complexes of the electrocardiogram alternate in height. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVElectrical alternans

Professional guidelines

PubMed

Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510

Recent clinical studies

Etiology

Diagnostic value of electrocardiogram in cardiac tamponade.
Ang KP, Nordin RB, Lee SCY, Lee CY, Lu HT
Med J Malaysia 2019 Feb;74(1):51-56. PMID: 30846663
Mechanisms linking electrical alternans and clinical ventricular arrhythmia in human heart failure.
Bayer JD, Lalani GG, Vigmond EJ, Narayan SM, Trayanova NA
Heart Rhythm 2016 Sep;13(9):1922-31. Epub 2016 May 20 doi: 10.1016/j.hrthm.2016.05.017. PMID: 27215536Free PMC Article
T-wave alternans and sudden cardiac death.
El-Menyar A, Asaad N
Crit Pathw Cardiol 2008 Mar;7(1):21-8. doi: 10.1097/HPC.0b013e318163f235. PMID: 18458663
Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510
Repolarization alternans: techniques, mechanisms, and cardiac vulnerability.
Murda'h MA, McKenna WJ, Camm AJ
Pacing Clin Electrophysiol 1997 Oct;20(10 Pt 2):2641-57. doi: 10.1111/j.1540-8159.1997.tb06113.x. PMID: 9358511

Diagnosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
Rapid Fire: Pericardial Effusion and Tamponade.
Honasoge AP, Dubbs SB
Emerg Med Clin North Am 2018 Aug;36(3):557-565. Epub 2018 Jun 11 doi: 10.1016/j.emc.2018.04.004. PMID: 30037442
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
Electrical alternans: a sign, not a diagnosis.
Goyal M, Woods KM, Atwood JE
South Med J 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c. PMID: 23912146
Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510

Therapy

Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
The electrical restitution curve revisited: steep or flat slope--which is better?
Franz MR
J Cardiovasc Electrophysiol 2003 Oct;14(10 Suppl):S140-7. doi: 10.1046/j.1540.8167.90303.x. PMID: 14760916
A novel approach to identifying antiarrhythmic drug targets.
Gilmour RF Jr
Drug Discov Today 2003 Feb 15;8(4):162-7. doi: 10.1016/s1359-6446(02)02567-9. PMID: 12581710
Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias.
Estes NA 3rd, Michaud G, Zipes DP, El-Sherif N, Venditti FJ, Rosenbaum DS, Albrecht P, Wang PJ, Cohen RJ
Am J Cardiol 1997 Nov 15;80(10):1314-8. doi: 10.1016/s0002-9149(97)00694-2. PMID: 9388105
Electrical alternans and cardiac electrical instability.
Smith JM, Clancy EA, Valeri CR, Ruskin JN, Cohen RJ
Circulation 1988 Jan;77(1):110-21. doi: 10.1161/01.cir.77.1.110. PMID: 3335062

Prognosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
Pericardial effusion and electrical alternans.
Singh H, Pannu AK, Suri V, Bhalla A, Kumari S
QJM 2019 Feb 1;112(2):135-136. doi: 10.1093/qjmed/hcy191. PMID: 30165695
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
Electrical alternans: a sign, not a diagnosis.
Goyal M, Woods KM, Atwood JE
South Med J 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c. PMID: 23912146
Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510

Clinical prediction guides

Mechanisms linking electrical alternans and clinical ventricular arrhythmia in human heart failure.
Bayer JD, Lalani GG, Vigmond EJ, Narayan SM, Trayanova NA
Heart Rhythm 2016 Sep;13(9):1922-31. Epub 2016 May 20 doi: 10.1016/j.hrthm.2016.05.017. PMID: 27215536Free PMC Article
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
T-wave alternans and sudden cardiac death.
El-Menyar A, Asaad N
Crit Pathw Cardiol 2008 Mar;7(1):21-8. doi: 10.1097/HPC.0b013e318163f235. PMID: 18458663
Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510
Cardiac alternans: diverse mechanisms and clinical manifestations.
Surawicz B, Fisch C
J Am Coll Cardiol 1992 Aug;20(2):483-99. doi: 10.1016/0735-1097(92)90122-4. PMID: 1634690

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