T-Wave Alternans (TWA)

What is a T-Wave Alternans:

Microvolt T-Wave alternans testing, also known as T-Wave alternans is a noninvasive technique used to identify patients who are at high or low risk for sudden cardiac death or cardiac arrest due to ventricular tachyarrhythmias. T-Wave alternans refers to a beat-to-beat variability in the amplitude of the risk stratification tool to predict the likelihood of fatal arrhythmias and sudden cardiac death in patients with a history of myocardial infarction or cardiomyopathy. Research has shown that a negative T-Wave alternans test result means there is very minimal risk of the patient developing ventricular tachyarrhythmia's and can therefore help shape the treatment plan by sparing the risk and expense of surgery for treatment team to explore more aggressive means of managing patient, such as medication or treatment with an ICD.

Insurance: It will be your responsibility to provide our office with your insurance card and a referral. If a referral is needed you will need to bring the original copy to the office with you. This is very important, as the test cannot be performed without a referral.

Cancellation:  This test requires coordination between your doctor and the test center. If you need to cancel this test you MUST notify our office 24 hours in advance.

Treadmill: You will be walking on the treadmill for about 5-15 minutes at a slow pace.

Clothing: Please wear comfortable clothing and appropriate shoes to walk in. No jewelry please. Women please wear Bra and NO dresses. Men please be advised that the test will involve shaving your chest. If you want to shave at home feel free to do so.

Time: The T-Wave Alternans test will take about 1 hour.

Medications:  Please bring your current medications wiht you. Stop the following medications 24 hours prior to test (unless you have chest pain on stopping medications):

Beta Blockers:

Acebutolol (Secral)

Bextaxolol (Kerlone)

Bisoprolol (Zebeta, Ziac)

Carvedilol (Coreg)

Labetalol (Normodyne, Trandate)

Metoprolol (Lopressor, Toprol XL0

Naldolol (Corgard)

Nebiuolol (Bystolic)

Penbutolol (Levatol)

Pindolol (Visken)

Propanolol (Inderal, InnoPran XL)

Sotalol (Betapace)

Tenormin (Atenolol)

Timolol (Blocadren)

Calcium Blockers:

Amlodipine (Caduet, Lotrel, Norvasc)

Diltiazem (Cardizem, Carta XT, Dilacor, Tizac, Taztia XT)

Felodipine (Plendil, Lexxel)

Isradipine (Dynacirc)

Nicardipine (Cardene)

Nifedipine (Procardia, Adalat, Nifedical, Nifediac)

Nisoldipine (Sular)

Verapamil (Calan, Covera, Veralan, Isoptin, Tarka)

Anti Arrythmic:

Amiodarone (Cordarone)

Digoxin (Lanoxin)

Dronedarone (Multaq)

Flecanide

Propaffenone (Rythmol)

Quinidine

Sotalol (Betapace)

Nitroglycerine Preparations:

Isosorbide Dinitrate (Isordil)

Isosorbide Monitrate (Imdur)

Nitrobid

Nitroglycerin Patch (Nitro-dur, Nitrodisc, Transderm-Nitro, Minitran)

Download T-Wave Instructions

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