Value of microvolt T-wave alternans for predicting patients who would benefit from implantable cardioverter-defibrillator therapy.
Despite considerable progress in the management of coronary artery disease and dilated cardiomyopathy, a substantial proportion of patients remains at the risk of life-threatening arrhythmic events. The Multicenter Automatic Defibrillator Implantation II and Sudden Cardiac Death Heart Failure studies have conclusively demonstrated that prophylactic implantable cardioverter-defibrillator (ICD) therapy reduces mortality among subjects with ischemic and nonischemic cardiomyopathy but at the expense of potentially unnecessary ICD implantation in a large percentage of patients. Microvolt T-wave alternans (MTWA), with a negative predictive value greater than 90%, holds promise for selecting the patients who would likely and patients not likely to benefit from ICD implantation. Accurate identification of high-risk patients by noninvasive MTWA may allow for improved widespread screening for sudden death prevention in the general population.
Haghjoo
Majid
M
Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. majid.haghjoo@gmail.com
Arya
Arash
A
Sadr-Ameli
Mohammad Ali
MA
D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000628:therapy*; D016757:Death, Sudden, Cardiac; D017147:Defibrillators, Implantable; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D011237:Predictive Value of Tests; D018570:Risk Assessment