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An unusual electrocardiographic abnormality
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Figure 1 shows a prolonged QT interval (corrected QT 520 milliseconds) and macroscopic T wave alternans. T wave alternans is defined as a beat to beat variation in the amplitude or polarity of the T wave. Macroscopic T wave alternans is a predictor of malignant ventricular arrhythmias.1 Microvolt T wave alternans is a validated predictor of mortality and morbidity in a variety of patient groups.1 This ECG anomaly is seen with both transient physiological stress (for example, exercise), and with pathological stress such as electrolyte abnormalities and myocardial ischaemia. Indeed, revascularisation in ischaemia has even been shown to reduce the incidence of T wave alternans.1 It has also been documented in association with the long QT and Brugada syndromes.2
T wave alternans on a millivolt scale visible to the naked eye (macroscopic T wave alternans) is predominantly a subject for individual case reports. It is often a precursor to the
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- An unusual electrocardiographic abnormality
- S Harris, M O’Neill, N Oliver, S Dubrey
Postgrad. Med. J. 2003 79: 539-540.[Extract] [Full Text] [PDF]
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