Aro Aapo L, Kenttä Tuomas V, Huikuri Heikki V
Helsinki University Hospital, Helsinki, Finland.
University Hospital of Oulu and University of Oulu, Oulu, Finland.
Arrhythm Electrophysiol Rev. 2016 May;5(1):37-40. doi: 10.15420/aer.2015.28.1.
Microvolt T-wave alternans (TWA), characterised as beat-to-beat fluctuation of T-wave amplitude and morphology, is an electrophysiological phenomenon associated clinically with impending ventricular arrhythmias and is an important marker of arrhythmia risk. Currently, two main methods for the detection of TWA exist, namely, the spectral method and the time-domain modified moving average method; both are discussed in this review. Microvolt TWA has been associated with cardiovascular mortality and sudden cardiac death in several clinical studies involving >14,000 subjects with reduced as well as preserved left ventricular function. Although TWA appears to be a useful marker of susceptibility for lethal ventricular arrhythmias and cardiovascular death, so far there is no sufficient evidence from randomised clinical trials to support its use in guiding therapy. However, several ongoing trials are expected to provide more information about the clinical use of TWA testing.
微伏级T波交替（TWA）表现为T波振幅和形态的逐搏波动，是一种与即将发生的室性心律失常相关的电生理现象，也是心律失常风险的重要标志物。目前，存在两种主要的TWA检测方法，即频谱法和时域修正移动平均法；本文将对这两种方法进行讨论。在涉及14000多名左心室功能减退及保留的受试者的多项临床研究中，微伏级TWA与心血管死亡率和心源性猝死相关。尽管TWA似乎是致死性室性心律失常和心血管死亡易感性的有用标志物，但迄今为止，尚无来自随机临床试验的充分证据支持将其用于指导治疗。然而，几项正在进行的试验有望提供更多关于TWA检测临床应用的信息。
