T Wave Alternans Assessment

Microvolt T-wave alternans testing, also known as T-wave alternans (TWA) is a noninvasive technique used to identify patients who are at high or low risk for sudden cardiac death or cardiac arrest due to ventricular tachyarrhythmias.  T-wave alternans refers to a beat-to-beat variability in the amplitude of the T-wave portion of the electrocardiogram (ECG) tracing. The presence of T-wave alternans has been investigated as a risk stratification tool to predict the likelihood of fatal arrhythmias and sudden cardiac death in patients with a history of myocardial infarction or cardiomyopathy. Research has shown that a negative T-wave alternans test result means there is very minimal risk of the patient developing ventricular tachyarrhythmias and can therefore help shape the treatment plan by sparing the risk and expense of surgery for treatment with an implantable cardioverter defibrillator (ICD), or pacemaker. Conversely, a positive test result will allow the treatment team to explore more aggressive means of managing the patient, such as medication or treatment with an ICD.

Source: Wellmark