T-wave alternans negative coronary patients with low ejection and benefit from defibrillator implantation.
In a trial of prophylactic implantation of a defibrillator, a mortality benefit was seen among patients with previous myocardial infarction and a left-ventricular ejection fraction of 0.30 or less. We identified 129 similar patients from two previously published clinical trials in which microvolt T-wave alternans testing was prospectively assessed. At 24 months of follow-up, no sudden cardiac death or cardiac arrest was seen among patients who tested T-wave alternans negative, compared with an event rate of 15.6% among the remaining patients. Testing of T-wave alternans seems to identify patients who are at low risk of ventricular tachyarrhythmic event and who may not benefit from defibrillator therapy.
Hohnloser
S H
SH
Johann Wolfgang Goethe University, Frankfurt, Germany.
Ikeda
T
T
Bloomfield
D M
DM
Dabbous
O H
OH
Cohen
R J
RJ
D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000517:prevention & control; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications*