# Electrical alternans

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> Source: https://en.wikipedia.org/wiki/Electrical_alternans
> Source revision: 1301052901
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{{Infobox medical condition (new)
| name            = Electrical alternans
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| image           = Electrical Alternans.JPG
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| caption         = Electrical alternans, [tachycardia](/source/tachycardia), and low voltage in a person with a large [pericardial effusion](/source/pericardial_effusion).
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| field           = [Cardiology](/source/Cardiology)
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'''Electrical alternans''' is an [electrocardiographic](/source/electrocardiogram) phenomenon of alternation of [QRS complex](/source/QRS_complex) amplitude or [axis](/source/Coordinate_axis) between beats and a possible wandering base-line. It can be seen in [cardiac tamponade](/source/cardiac_tamponade) and severe [pericardial effusion](/source/pericardial_effusion) and is thought to be related to changes in the [ventricular](/source/ventricle_(heart)) electrical axis due to fluid in the [pericardium](/source/pericardium), as the heart essentially wobbles in the fluid filled pericardial sac.<ref name=Antonio>{{cite book|title=Clinical Arrhythmology|author=Antonio Bayés de Luna|publisher=John Wiley and Sons|year=2011|page=351|url=https://books.google.com/books?id=imwpNCqooDQC&dq=electrical+alternans&pg=PA351|isbn=9781444391732}}</ref> It can also be found in other conditions, such as bidirectional ventricular tachycardia from digoxin toxicity <ref>{{Cite web |title=Electrical Alternans Differential Diagnoses |url=https://emedicine.medscape.com/article/154706-differential |access-date=2024-12-12 |website=emedicine.medscape.com |language=en}}</ref>  and atrioventricular tachycardia. <ref>{{Cite journal |last1=Amasyali |first1=Basri |last2=Kose |first2=Sedat |last3=Çelik |first3=Turgay |date=2006-02-01 |title=Atrioventricular nodal re-entrant tachycardia with QRS voltage and cycle length alternation and aberrant conduction due to two distinct antegrade slow pathways |url=https://academic.oup.com/europace/article/8/2/134/439010 |journal=EP Europace |volume=8 |issue=2 |pages=134–137 |doi=10.1093/europace/euj033 |issn=1099-5129}}</ref>

The [echocardiogram](/source/echocardiogram) of the heart demonstrated the characteristic swinging along with alternating voltage on the [ECG](/source/ECG).<ref name="Jehangir Osman 2015 p. e10">{{cite journal | last1=Jehangir | first1=Waqas | last2=Osman | first2=Mohamed | title=Electrical Alternans with Pericardial Tamponade | journal=New England Journal of Medicine | volume=373 | issue=8 | date=2015-08-20 | issn=0028-4793 | doi=10.1056/NEJMicm1408805 | page=e10| pmid=26287870 }}</ref>

==Causes==
The two most common causes of electrical alternans are [cardiac tamponade](/source/cardiac_tamponade) and [pericardial effusion](/source/pericardial_effusion). In this case, the heart's pendulum-like motion and rotation from beat to beat, which the [ECG](/source/ECG) electrodes detect as varying amplitudes, is what causes the classic ECG rhythm. In addition, electrical alternans can be observed in conduction and refractory changes in a variety of [rhythms](/source/Heart_rhythm), including the ones previously mentioned, which causes the electrodes to detect a range of [QRS](/source/QRS_complex) amplitudes.<ref name="Ingram Strecker-McGraw 2023 f900">{{cite web | last1=Ingram | first1=David | last2=Strecker-McGraw | first2=Margaret K. | title=Electrical Alternans | publisher=StatPearls Publishing | date=April 7, 2023 | pmid=30480962 |url=https://www.ncbi.nlm.nih.gov/books/NBK534229/ | access-date=December 29, 2023}}</ref>

==See also==
* [Cardiac tamponade](/source/Cardiac_tamponade)
* [Electrocardiogram](/source/Electrocardiogram)

==References==
{{reflist}}

==Further reading==
* {{cite journal | last1=M | first1=Goyal | last2=KM | first2=Woods | last3=JE | first3=Atwood | title=Electrical alternans: a sign, not a diagnosis | journal=Southern Medical Journal | date=August 2013 | publisher=South Med J | volume=106 | issue=8 | pages=485–489 | issn=1541-8243 | pmid=23912146 | doi=10.1097/SMJ.0b013e3182a1456c | s2cid=19681969 | ref=none}}
* {{cite book | last=Mittal | first=Sitaram | title=Insights into Electrocardiograms with MCQs | chapter=Electrical Alternans | publisher=Springer Nature Singapore | publication-place=Singapore | date=2023 | pages=681–684 | isbn=978-981-99-0126-5 | doi=10.1007/978-981-99-0127-2_47 | ref=none}}

==External links==
{{Medical resources
| ICD11           = {{ICD11|MC81.Y}}
| ICD10           = {{ICD10|R00.8}}
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| eMedicineTopic  = 154706
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{{Heart diseases|state=collapsed}}

{{DEFAULTSORT:Electrical Alternans}}
Category:Cardiac arrhythmia

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Adapted from the Wikipedia article [Electrical alternans](https://en.wikipedia.org/wiki/Electrical_alternans) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Electrical_alternans?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.