{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:01:23Z","timestamp":1790938883113,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,3,15]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>T-wave alternans (TWA) increases before ventricular tachycardia (VT) or fibrillation (VF), suggesting that it may warn of VT\/VF in implantable cardioverter-defibrillator patients. Recently, we described a method for measuring alternans and nonalternans variability (TWA\/V) from electrograms (EGMs) stored in implantable cardioverter-defibrillators before VT\/VF. The goal of this prospective, multicenter study was to determine whether EGM TWA\/V was greater before VT\/VF than at baseline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We enrolled 63 implantable cardioverter-defibrillator patients. TWA\/V was computed from stored EGMs before spontaneous VT\/VF and from sequential windows of 8 pairs of beats using 4 different control recordings: baseline rhythm, rapid pacing at 105 bpm, segments of ambulatory Holter EGMs matched to the time of VT\/VF episodes, and EGMs before spontaneous supraventricular tachycardia. During follow-up, 28 patients had 166 episodes of VT\/VF. TWA\/V was greater before VT\/VF (62.9\u00b13.1 \u03bcV; n=28) than during baseline rhythm (12.8\u00b11.8 \u03bcV;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; n=62), during rapid pacing (14.5\u00b12.0 \u03bcV;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; n=52), before supraventricular tachycardia (27.5\u00b16.1 \u03bcV;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; n=9), or during time-matched ambulatory controls (12.3\u00b13.5 \u03bcV;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; n=16). By logistic regression, the odds of VT\/VF increased by a factor of 2.2 for each 10-\u03bcV increment in TWA\/V (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In implantable cardioverter-defibrillator patients, EGM TWA\/V is greater before spontaneous VT\/VF than in control recordings. Future implantable cardioverter-defibrillators that measure EGM TWA\/V continuously may warn patients and initiate pacing therapies to prevent VT\/VF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.110.986364","type":"journal-article","created":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T21:11:39Z","timestamp":1299013899000},"page":"1052-1060","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Intracardiac Electrogram T-Wave Alternans\/Variability Increases Before Spontaneous Ventricular Tachyarrhythmias in Implantable Cardioverter-Defibrillator Patients"],"prefix":"10.1161","volume":"123","author":[{"given":"Charles","family":"Swerdlow","sequence":"first","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Chow","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mithilesh","family":"Das","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Gillis","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Zhou","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athula","family":"Abeyratne","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja N.","family":"Ghanem","sequence":"additional","affiliation":[{"name":"From the Cedars-Sinai Heart Institute, Los Angeles, CA (C.S.); Ohio Heart and Vascular Center, Cincinnati (T.C.); Indiana University School of Medicine, Indianapolis (M.D.); Faculty of Medicine University of Calgary, Calgary, AB, Canada (A.M.G.); and Medtronic, Inc, Mounds View, MN (X.Z., A.A., R.N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.res.0000038887.17976.33"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.87.12.1103"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1063\/1.166024"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2005.847537"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.77.1.110"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00051.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.607895"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401273300402"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000143160.14610.53"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.066"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.03.022"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2003.09.059"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2004.03411.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2003.813535"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.02.018"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-08-0311"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.21.2550"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201233260414"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00592.2001"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.02.018"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.12.011"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.026"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfp138"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2008.01074.x"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2007.00633.x"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup253"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2004.12.010"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.01.021"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.110.986364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:09:03Z","timestamp":1715580543000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.110.986364"}},"subtitle":["A Prospective, Multi-Center Study"],"short-title":[],"issued":{"date-parts":[[2011,3,15]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2011,3,15]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.110.986364"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.110.986364","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,15]]},"assertion":[{"value":"2010-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-01-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-02-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}