Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction : A prospective study

The aim of the present study was to determine whether the combination of two markers that reflect depolarization and repolarization abnormalities can predict future arrhythmic events after acute myocardial infarction (MI). Although various noninvasive markers have been used to predict arrhythmic events after MI, the positive predictive value of the markers remains low. We prospectively assessed T-wave alternans (TWA) and late potentials (LP) by signal-averaged electrocardiogram (ECG) and ejection fraction (EF) in 102 patients with successful determination results after acute MI. The TWA was analyzed using the power-spectral method during supine bicycle exercise testing. No antiarrhythmic drugs were used during the follow-up period. The study end point was the documentation of ventricular arrhythmias. The TWA was present in 50 patients (49%), LP present in 21 patients (21%), and an EF