T Wave Alternans and Ventricular Arrhythmias in Arterial Hypertension

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2001-02, Vol.37 (2), p.199-203
• Main Authors: Hennersdorf, Marcus G, Niebch, Verena, Perings, Christian, Strauer, Bodo-E
• Format: Article
• Language: English
• Subjects: Adult; Arrhythmias, Cardiac - physiopathology; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Electrocardiography; Electrocardiography, Ambulatory; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Humans; Hypertension - physiopathology; Hypertrophy, Left Ventricular - physiopathology; Medical sciences; Middle Aged; Tachycardia, Ventricular - physiopathology
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.HYP.37.2.199

Patients with a positive microvolt-level T wave alternans (TWA) are characterized by an increased risk of ventricular tachyarrhythmias. Arterial hypertension leads to an increase of sudden cardiac death risk, particularly if left ventricular hypertrophy is present. The aim of this study was to investigate the value of TWA in patients with arterial hypertension. Fifty-one consecutive patients were included in the study. TWA analysis was performed with patients sitting on a bicycle ergometer and exercising with a gradual increase of workload to maintain a heart rate of at least 105/min. After recording 254 consecutive low-noise-level heartbeats, the exercise test was stopped. The ECG signals were digitally processed by a spectral analysis method. The magnitude of TWA was measured at a frequency of 0.5 cycle per beat. A TWA was defined as positive if the ratio between TWA and noise level was >3.0 and the amplitude of the TWA was >1.8 μV. Eight of the 51 patients (16%) showed a positive TWA. If left ventricular hypertrophy was present, the prevalence of TWA was higher (33.3% versus 8.3%;P