T-Wave Alternans Test Instructions Brief explanation of sequence of test: 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-tobeat 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. Time: The T-Wave Alternans test will take about 1 hour. Treadmill time is about 5-15 minutes (slow pace). 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. Clothing: Please wear comfortable clothing (short sleeves, no metal snaps or buttons) and appropriate shoes to walk in. Ladies please wear a bra and do not wear a dress. Please no jewelry. Do not use bath oil, lotion, or powder on the morning of the test. You may use deodorant if desired. Men please be advised that the test will involve shaving your chest. If you want to shave at home feel free to do so. Insurance: It is your responsibility to provide our office with your insurance card and referral. If a referral is needed you will need to bring the original copy to our office with you. This is very important, as the test can not be preformed without a referral. Medications: Please bring your medication bottles or a list of your current medications with you. You will be required to stop certain medications 24 hours prior to the test. 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 XL) 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 Arrhythmic: Amiodarone (Cordarone) Digoxin (Lanoxin) Dronedarone (Multaq) Flecanide Propaffenone (Rythmol) Quinidine Sotalol (Betapace) Nitroglycerine Preparations: Isosorbide Dinitrate (Isordil) Isosorbide Monitrate (Imdur) Nitrobid Nitroglycerin Patch (Nitrodur, Nitrodisc, TransdermN