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微伏级T波电交替(MTWA)是指T波形态、幅度、极性在微伏级水平发生规律变化,是一个有希望的心源性猝死危险分层的无创方法。MTWA判断标准:①阳性:踏车运动,心率<110次/分时T波交替幅度>1.9μV且持续1 min以上,交替率>3;②阴性:不符合阳性标准,心率≥110次/分时持续1 min无明显的交替,噪音引起记录不清晰,以及<10%房(室)性早搏;③不能确定:≥10%房(室)性早搏、房室结文氏现象和噪音引起的过多干扰。MTWA主要用于筛选植入ICD一级预防的患者,MTWA阴性预测价值高,阳性或不能确定时需联合左室射血分数或电生理检查结果综合判断。
Microvolt T wave alternation (MTWA) refers to the T wave morphology, amplitude, polarity changes occur at a microvolt level, is a promising non-invasive method of risk stratification of sudden cardiac death. MTWA criteria: ① positive: treadmill exercise, heart rate <110 beats / min T wave amplitude> 1.9μV and continued for more than 1 min, the alternation rate> 3; ② negative: does not meet the positive criteria, heart rate ≥ 110 beats / min No obvious alternation occurred for 1 min, the noise was not recorded clearly, and <10% premature ventricular contractions were confirmed. ③ Not sure: ≥10% premature ventricular premature beats, atrioventricular von Wiegand phenomenon and noise Too much interference. MTWA is mainly used to screen patients with ICD primary prevention, MTWA negative predictive value is high, positive or not sure to be combined with left ventricular ejection fraction or electrophysiological results of comprehensive judgment.