The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Mechanism Linking T-Wave Alternans to the Genesis of Cardiac Fibrillation
Abstract
Background —Although T-wave alternans has been closely associated with vulnerability to ventricular arrhythmias, the cellular processes underlying T-wave alternans and their role, if any, in the mechanism of reentry remain unclear. Methods and Results —T-wave alternans on the surface ECG was elicited in 8 Langendorff-perfused guinea pig hearts during fixed-rate pacing while action potentials were recorded simultaneously from 128 epicardial sites with voltage-sensitive dyes. Alternans of the repolarization phase of the action potential was observed above a critical threshold heart rate (HR) (209±46 bpm) that was significantly lower (by 57±36 bpm) than the HR threshold for alternation of action potential depolarization. The magnitude (range, 2.7 to 47.0 mV) and HR threshold (range, 171 to 272 bpm) of repolarization alternans varied substantially between cells across the epicardial surface. T-wave alternans on the surface ECG was explained primarily by beat-to-beat alternation in the time course of cellular repolarization. Above a critical HR, membrane repolarization alternated with the opposite phase between neighboring cells (ie, discordant alternans), creating large spatial gradients of repolarization. In the presence of discordant alternans, a small acceleration of pacing cycle length produced a characteristic sequence of events: (1) unidirectional block of an impulse propagating against steep gradients of repolarization, (2) reentrant propagation, and (3) the initiation of ventricular fibrillation. Conclusions —Repolarization alternans at the level of the single cell accounts for T-wave alternans on the surface ECG. Discordant alternans produces spatial gradients of repolarization of sufficient magnitude to cause unidirectional block and reentrant ventricular fibrillation. These data establish a mechanism linking T-wave alternans of the ECG to the pathogenesis of sudden cardiac death.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Luo, C. H., & Rudy, Y. (1991) · Circulation Research · doi:10.1161/01.res.68.6.1501 · Cited by 1,468
Electrical Alternans and Vulnerability to Ventricular Arrhythmias
Rosenbaum, D. S., Jackson, L. E., Smith, J. M., Garan, H., Ruskin, J. N., & Cohen, R. J. (1994) · New England Journal of Medicine · doi:10.1056/nejm199401273300402 · Cited by 1,143
Self-citationKuo, C. S., Munakata, K., Reddy, C. P., & Surawicz, B. (1983) · Circulation · doi:10.1161/01.cir.67.6.1356 · Cited by 747
Schwartz, P. J., & Malliani, A. (1975) · American Heart Journal · doi:10.1016/0002-8703(75)90008-3 · Cited by 524
Electrical alternans and cardiac electrical instability.
Smith, J. M., Clancy, E. A., Valeri, C. R., Ruskin, J. N., & Cohen, R. J. (1988) · Circulation · doi:10.1161/01.cir.77.1.110 · Cited by 504
Downar, E., Janse, M. J., & Durrer, D. (1977) · Circulation · doi:10.1161/01.cir.56.2.217 · Cited by 450
ROSENBAUM, D. S., ALBRECHT, P., & COHEN, R. J. (1996) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1996.tb00487.x · Cited by 179
Self-citationGirouard, S. D., Pastore, J. M., Laurita, K. R., Gregory, K. W., & Rosenbaum, D. S. (1996) · Circulation · doi:10.1161/01.cir.93.3.603 · Cited by 168
Self-citationT Wave Alternans During Exercise and Atrial Pacing in Humans
HOHNLOSER, S. H., KLINGENHEBEN, T., ZABEL, M., LI, Y., ALBRECHT, P., & COHEN, R. J. (1997) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1997.tb00621.x · Cited by 163
Effect of Heart Rate on Cardiac Membrane Potentials and the Unipolar Electrogram
Hoffman, B. F., & Suckling, E. E. (1954) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1954.179.1.123 · Cited by 157
Cited by
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., et al. (2008) · Circulation · doi:10.1161/circulationaha.107.189375 · Cited by 1,450
Fishman, G. I., Chugh, S. S., DiMarco, J. P., Albert, C. M., Anderson, M. E., Bonow, R. O., Buxton, A. E., Chen, P.-S., Estes, M., Jouven, X., et al. (2010) · Circulation · doi:10.1161/circulationaha.110.976092 · Cited by 614
Self-citationMultiple mechanisms of spiral wave breakup in a model of cardiac electrical activity
Fenton, F. H., Cherry, E. M., Hastings, H. M., & Evans, S. J. (2002) · Chaos: An Interdisciplinary Journal of Nonlinear Science · doi:10.1063/1.1504242 · Cited by 559
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.05.003 · Cited by 428
Akar, F. G., Yan, G.-X., Antzelevitch, C., & Rosenbaum, D. S. (2002) · Circulation · doi:10.1161/hc1002.105231 · Cited by 302
Self-citation
Metadata
- Authors
- Pastore, J. M., Girouard, S. D., Laurita, K. R., Akar, F. G., & Rosenbaum, D. S.
- Venue
- Circulation
- Published
- 1999-03-16
- Volume
- 99
- Issue
- 10
- Pages
- 1385-1394
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2077129671
- Cited by
- 817
- References
- 21
- FWCI
- 18.56
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Mechanism Linking T-Wave Alternans to the Genesis of Cardiac Fibrillation. https://app.cochat.ai/papers/10.1161/01.cir.99.10.1385
- The paper
- Pastore, J. M., Girouard, S. D., Laurita, K. R., Akar, F. G., & Rosenbaum, D. S. (1999). Mechanism Linking T-Wave Alternans to the Genesis of Cardiac Fibrillation. Circulation. https://doi.org/10.1161/01.cir.99.10.1385
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
