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Science 19 April 1991:
Vol. 252. no. 5004, pp. 437 - 440
DOI: 10.1126/science.2017682
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Articles

Science, Vol 252, Issue 5004, 437-440
Copyright © 1991 by American Association for the Advancement of Science

articles

Dynamic tracking of cardiac vulnerability by complex demodulation of the T wave

BD Nearing, AH Huang, and RL Verrier

Georgetown University School of Medicine, Washington, DC 20007.

A link is found between T wave alternans and vulnerability to ventricular fibrillation, and a new approach is provided for quantification of susceptibility to malignant arrhythmias. Complex demodulation reveals that alternation of the electrocardiogram is concentrated during the first half of the T wave, coinciding with the vulnerable period of the cardiac cycle. During myocardial ischemia and reperfusion, there are marked increases in the degree of T wave alternans that parallel the established time course of changes in vulnerability. The influence of the sympathetic nervous system in arrhythmogenesis is also accurately detected. Ultimately, complex demodulation of the electrocardiogram could provide a technique for identification and management of individuals at risk for sudden cardiac death.


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