Predictive Value of Microvolt T-Wave Alternans in Patients With Left Ventricular Dysfunction

Predictive Value of Microvolt T-Wave Alternans in Patients With Left Ventricular Dysfunction Daniel J. Cantillon, Kenneth M. Stein, Steven M. Markowitz, Suneet Mittal, Bindi K. Shah, Daniel P. Morin, Eran S. Zacks, Matthew Janik, Shaun Ageno, Andreas C. Mauer, Bruce B. Lerman, Sei Iwai We evaluated...

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Veröffentlicht in:	Journal of the American College of Cardiology 2007-07, Vol.50 (2), p.166-173
Hauptverfasser:	Cantillon, Daniel J., MD, Stein, Kenneth M., MD, FACC, Markowitz, Steven M., MD, FACC, Mittal, Suneet, MD, FACC, Shah, Bindi K., MD, FACC, Morin, Daniel P., MD, MPH, Zacks, Eran S., MD, Janik, Matthew, MD, Ageno, Shaun, MD, Mauer, Andreas C., MD, Lerman, Bruce B., MD, FACC, Iwai, Sei, MD, FACC
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Analysis of Variance Arrhythmias, Cardiac - diagnosis Cardiac arrhythmia Cardiology Cardiomyopathy Cardiovascular Confidence intervals Consent Death, Sudden, Cardiac Disease-Free Survival Electrophysiologic Techniques, Cardiac Female Heart Heart attacks Humans Internal Medicine Kaplan-Meier Estimate Male Middle Aged Mortality Myocardial Ischemia - complications Observation Prognosis Prospective Studies Risk Assessment Stroke Volume Ventricular Dysfunction, Left - complications Ventricular Dysfunction, Left - physiopathology
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Zusammenfassung:	Predictive Value of Microvolt T-Wave Alternans in Patients With Left Ventricular Dysfunction Daniel J. Cantillon, Kenneth M. Stein, Steven M. Markowitz, Suneet Mittal, Bindi K. Shah, Daniel P. Morin, Eran S. Zacks, Matthew Janik, Shaun Ageno, Andreas C. Mauer, Bruce B. Lerman, Sei Iwai We evaluated the utility of microvolt T-wave alternans (TWA) in predicting arrhythmia-free survival and total mortality in patients with left ventricular (LV) dysfunction and syncope and/or nonsustained ventricular tachycardia. Two hundred eighty-six patients with an ejection fraction ≤35% underwent TWA and electrophysiologic testing. Improved arrhythmia-free survival (81% vs. 66% at 2 years; p < 0.001) and lower 2-year total mortality (10% vs. 18%; p = 0.04) were demonstrated in TWA-negative patients. Although TWA predicts arrhythmia-free survival among patients with LV dysfunction, the event rate in the TWA-negative group suggests that TWA may not be capable of identifying a sufficiently low-risk subset to obviate the need for ICD implantation.
ISSN:	0735-1097 1558-3597
DOI:	10.1016/j.jacc.2007.02.069