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Electrical alternans

MedGen UID:
215131
•Concept ID:
C1142551
•
Finding
Synonyms: Electrical Alternans; Electrical Alternans by ECG Finding; Electrical Alternans by EKG Finding; Electrical alternation of heart
SNOMED CT: Electrical alternation of heart (423863005); Electrical alternans (423863005)
 
HPO: HP:0025078

Definition

The QRS complexes of the electrocardiogram alternate in height. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVElectrical alternans

Professional guidelines

PubMed

Clinical utility of T-wave alternans.
Armoundas AA, Cohen RJ
Card Electrophysiol Rev 1997;1(3):390-4. doi: 10.1023/a:1009902030340. PMID: 11541510

Recent clinical studies

Etiology

Sophoridine manifests as a leading compound for anti-arrhythmia with multiple ion-channel blocking effects.
Song T, Hao Y, Wang M, Li T, Zhao C, Li J, Hou Y
Phytomedicine 2023 Apr;112:154688. Epub 2023 Jan 31 doi: 10.1016/j.phymed.2023.154688. PMID: 36738478
Mechanisms linking electrical alternans and clinical ventricular arrhythmia in human heart failure.
Bayer JD, Lalani GG, Vigmond EJ, Narayan SM, Trayanova NA
Heart Rhythm 2016 Sep;13(9):1922-31. Epub 2016 May 20 doi: 10.1016/j.hrthm.2016.05.017. PMID: 27215536Free PMC Article
T-wave alternans and sudden cardiac death.
El-Menyar A, Asaad N
Crit Pathw Cardiol 2008 Mar;7(1):21-8. doi: 10.1097/HPC.0b013e318163f235. PMID: 18458663
Linkage between mechanical and electrical alternans in patients with chronic heart failure.
Kodama M, Kato K, Hirono S, Okura Y, Hanawa H, Yoshida T, Hayashi M, Tachikawa H, Kashimura T, Watanabe K, Aizawa Y
J Cardiovasc Electrophysiol 2004 Mar;15(3):295-9. doi: 10.1046/j.1540-8167.2004.03016.x. PMID: 15030419
Electrical alternans and vulnerability to ventricular arrhythmias.
Rosenbaum DS, Jackson LE, Smith JM, Garan H, Ruskin JN, Cohen RJ
N Engl J Med 1994 Jan 27;330(4):235-41. doi: 10.1056/NEJM199401273300402. PMID: 8272084

Diagnosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
Pericardial effusion and electrical alternans.
Singh H, Pannu AK, Suri V, Bhalla A, Kumari S
QJM 2019 Feb 1;112(2):135-136. doi: 10.1093/qjmed/hcy191. PMID: 30165695
Rapid Fire: Pericardial Effusion and Tamponade.
Honasoge AP, Dubbs SB
Emerg Med Clin North Am 2018 Aug;36(3):557-565. Epub 2018 Jun 11 doi: 10.1016/j.emc.2018.04.004. PMID: 30037442
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
Electrical alternans: a sign, not a diagnosis.
Goyal M, Woods KM, Atwood JE
South Med J 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c. PMID: 23912146

Therapy

Sophoridine manifests as a leading compound for anti-arrhythmia with multiple ion-channel blocking effects.
Song T, Hao Y, Wang M, Li T, Zhao C, Li J, Hou Y
Phytomedicine 2023 Apr;112:154688. Epub 2023 Jan 31 doi: 10.1016/j.phymed.2023.154688. PMID: 36738478
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
The electrical restitution curve revisited: steep or flat slope--which is better?
Franz MR
J Cardiovasc Electrophysiol 2003 Oct;14(10 Suppl):S140-7. doi: 10.1046/j.1540.8167.90303.x. PMID: 14760916
A novel approach to identifying antiarrhythmic drug targets.
Gilmour RF Jr
Drug Discov Today 2003 Feb 15;8(4):162-7. doi: 10.1016/s1359-6446(02)02567-9. PMID: 12581710
Electrical alternans and cardiac electrical instability.
Smith JM, Clancy EA, Valeri CR, Ruskin JN, Cohen RJ
Circulation 1988 Jan;77(1):110-21. doi: 10.1161/01.cir.77.1.110. PMID: 3335062

Prognosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
Pericardial effusion and electrical alternans.
Singh H, Pannu AK, Suri V, Bhalla A, Kumari S
QJM 2019 Feb 1;112(2):135-136. doi: 10.1093/qjmed/hcy191. PMID: 30165695
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
Electrical alternans: a sign, not a diagnosis.
Goyal M, Woods KM, Atwood JE
South Med J 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c. PMID: 23912146
Electrical alternans and cardiac electrical instability.
Smith JM, Clancy EA, Valeri CR, Ruskin JN, Cohen RJ
Circulation 1988 Jan;77(1):110-21. doi: 10.1161/01.cir.77.1.110. PMID: 3335062

Clinical prediction guides

Mechanisms linking electrical alternans and clinical ventricular arrhythmia in human heart failure.
Bayer JD, Lalani GG, Vigmond EJ, Narayan SM, Trayanova NA
Heart Rhythm 2016 Sep;13(9):1922-31. Epub 2016 May 20 doi: 10.1016/j.hrthm.2016.05.017. PMID: 27215536Free PMC Article
Geometrical considerations in cardiac electrophysiology and arrhythmogenesis.
Winter J, Shattock MJ
Europace 2016 Mar;18(3):320-31. Epub 2015 Nov 19 doi: 10.1093/europace/euv307. PMID: 26585597
The dancing heart.
Richardson JD, Turley AJ, Wright RA
Eur Heart J Acute Cardiovasc Care 2016 Feb;5(1):96-7. Epub 2014 Dec 1 doi: 10.1177/2048872614560503. PMID: 25452560
Cardiac alternans: diverse mechanisms and clinical manifestations.
Surawicz B, Fisch C
J Am Coll Cardiol 1992 Aug;20(2):483-99. doi: 10.1016/0735-1097(92)90122-4. PMID: 1634690
Electrical alternans and cardiac electrical instability.
Smith JM, Clancy EA, Valeri CR, Ruskin JN, Cohen RJ
Circulation 1988 Jan;77(1):110-21. doi: 10.1161/01.cir.77.1.110. PMID: 3335062

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