Methodological principles of T wave alternans analysis: a unified framework

Visible T wave alternans (TWA) in the electrocardiogram (ECG) had been regarded as an infrequent phenomenon during the first 80 years of electrocardiography. Nevertheless, computerized analysis changed this perception. In the last two decades, a variety of techniques for automatic TWA analysis have been proposed. These techniques have allowed researchers to detect nonvisible TWA in a wide variety of clinical and experimental conditions. Such studies have recently shown that TWA is related to cardiac instability and increased arrhythmogenicity. Comparison of TWA analysis methods is a difficult task due to the diversity of approaches. In this paper, we propose a unified framework which holds the existing methods. In the light of this framework, the methodological principles of the published TWA analysis schemes are compared and discussed. This framework may have an important role to develop new approaches to this problem.