Montgomery Heart & Wellness
MicroVolt T-Wave Alternans Test (MTWA) | Montgomery Heart & Wellness
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MicroVolt T-Wave Alternans Test

Patient Education

The Microvolt T-Wave Alternans (MTWA) Test is a non-invasive test to identify patients at risk of life threatening heart rhythm disturbances that can lead to sudden cardiac arrest. If you have had a stress test then you have had a test which is very similar to a MTWA test. If your doctor ordered this test for you, it’s because you may be at risk for sudden cardiac arrest. Most people who suffer a cardiac arrest episode have an underlying, pre-identifiable, electrical disorder that puts them at risk. Microvolt T-Wave Alternans testing can identify many of those electrical disorders and therefore people at risk for sudden cardiac arrest. The Microvolt T-Wave Alternans test requires that your heart rate is raised for a short time. Therefore, the test will most likely be performed using a treadmill. A nurse or technologist will apply sensors to multiple spots on your chest and back. These electrodes are connected to a wire that leads back to the Microvolt T-Wave Alternans equipment. The nurse or technologist will ask you to begin walking on a treadmill to raise your heart rate. The exercise portion of the test will be approximately 8-10 minutes. Information about your heart will be collected at three different times – during rest, while you walk on the treadmill and after the exercise. Having the test is no more difficult than taking a brisk walk. Once the test is complete, your physician will review the test results and if abnormal may recommend further evaluation. If further evaluation is recommended, your physician may refer you to an electrophysiologist (a cardiologist that specializes in heart rhythms).

About SCD

Sudden Cardiac Death, sometimes referred to as Sudden Cardiac Arrest, is a failure in the heart’s electrical system in which the heart stops suddenly and without warning. In the US, over 400,000 adults die each year from sudden cardiac arrest. Sudden cardiac arrest differs from a heart attack, also called a myocardial infarction, in that a myocardial infarction results when a part of the heart is starved of oxygen – called ischemia. This happens when a clot or blockage obstructs one of the arteries that supply blood to the heart. Sudden cardiac arrest is caused by life-threatening ventricular arrhythmias. One of the most common arrhythmias is called ventricular fibrillation. This is when the lower chambers of the heart quiver and are incapable of pumping blood out to the rest of the body. A victim of sudden cardiac arrest immediately stops breathing, has little or no detectable pulse and, with no intervention, will die within minutes. Most people who suffer from a ventricular arrhythmia have an underlying electrical disorder of the heart that can usually be detected by the Microvolt T-Wave Alternans (MTWA) Test. Any one can be a victim of sudden cardiac arrest but some people are at greater risk. These are people with:
  • a previous history of cardiac arrest or life threatening ventricular arrhythmias
  • documented heart disease and symptoms of possible arrhythmias such as fainting
  • elevated risk including patients with
  • congestive heart failure
  • prior heart attack
  • family history of sudden death and coronary artery disease.

MTWA Testing

The Microvolt T-Wave Alternans (MTWA) Test is a non-invasive diagnostic test that uses special electrodes that are placed on the chest and attached to a computer to examine how the electrical system of your heart operates. MTWA testing measures very small voltage changes between your heartbeats. These alterations in the beats are called alternans and the presence of alternans have been associated with an increased likelihood of life threatening ventricular arrhythmias or abnormal heartbeats. Most of the time, these T-wave variations are not visible to the naked eye when a routine ECG or stress test is performed. The Microvolt T-Wave Alternans test permits measurement of the T-waves at a microvolt level (one millionth of a volt), allowing your doctor to evaluate variations of the T-Wave that may have otherwise been missed without use of this specialized test. Extensive clinical studies have demonstrated that a normal or negative MTWA test indicates a very low risk of sudden cardiac arrest. IF YOU TAKE COREG, TOPROL XL, METOPROLOL, OR ANY ANTI-ARRHYTHMIA DRUGS PLEASE ASK ABOUT TAKING IT BEFORE YOUR TEST.

Microvolt T-Wave AlternansTM


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