T-Wave Variability as a Risk Stratifier in Patients with Dilated Cardiomyopathy
- 1 March 2009
- journal article
- research article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 32, S155-S157
- https://doi.org/10.1111/j.1540-8159.2008.02274.x
Abstract
T-wave alternans is an important identifier of patients at risk of sudden cardiac death (SCD), but the procedure usually requires stress testing. In this study, the variability of T-wave amplitude (TVAR) was evaluated at rest, as a risk stratifier for SCD.This study included 57 patients in sinus rhythm and with a left ventricular ejection fraction < or =40%, of whom 34 (60%) received an implantable cardioverter-defibrillator (ICD) after surviving SCD, and 23 (40%) presented with ischemic or nonischemic cardiomyopathy and no history of SCD. A 20-minute high-resolution electrocardiographic recording for TVAR assessment was performed during supine rest. The vector magnitude was used as a primary lead for TVAR analysis.The mean, median, and maximum (max) values of TVAR were measured. The patients with ICD had a lower max TVAR than the patients without ICD (67 vs 95 muV; P = 0.045), though the mean and median TVAR values were similar. By multivariate logistic analysis, max TVAR remained a predictor of SCD, after adjustments for potentially confounding factors (P = 0.044).Max TVAR was a predictor of arrhythmic events in patients with dilated cardiomyopathy at rest.Keywords
This publication has 11 references indexed in Scilit:
- The novel role of Micro T-Wave alternans in arrhythmic risk stratification of patients with left ventricular dysfunctionInternational Journal of Cardiology, 2007
- Risk stratification for arrhythmic sudden cardiac deathHeart Rhythm, 2006
- ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac DeathCirculation, 2006
- Microvolt T-Wave Alternans Distinguishes Between Patients Likely and Patients Not Likely to Benefit From Implanted Cardiac Defibrillator TherapyCirculation, 2004
- Interpretation and Classification of Microvolt T Wave Alternans TestsJournal of Cardiovascular Electrophysiology, 2002
- Expanding Indications for Implantable Cardiac DefibrillatorsNew England Journal of Medicine, 2002
- Prophylactic Implantation of a Defibrillator in Patients with Myocardial Infarction and Reduced Ejection FractionNew England Journal of Medicine, 2002
- T-wave alternans as a predictor for sudden cardiac death after myocardial infarctionThe American Journal of Cardiology, 2002
- Predictive value of T-wave alternans for arrhythmic events in patients with congestive heart failureThe Lancet, 2000
- T Wave Alternans as a Predictor of Recurrent Ventricular Tachyarrhythmias in ICD Recipients: Prospective Comparison with Conventional Risk MarkersJournal of Cardiovascular Electrophysiology, 1998