title: Ventricular arrhythmias in competitive athletes: risk stratification with T-wave alternans.
abstract: BACKGROUND
  Aim of our study is to evaluate the role of TWA to stratify the risk of sudden cardiac death in athletes (Ath) with complex ventricular arrhythmias (VA), and to document a possible correlation between TWA and electrophysiological testing (EES) results.
  
  
  METHODS
  We studied 43 Ath with VA (31 M, mean age 34 ± 12 years). In all cases a cardiological evaluation was performed, including TWA and EES. The patients were evaluated during a follow-up of 25 ± 22 months. The end-point was the occurrence of sudden death or malignant ventricular tachyarrhythmias (VT).
  
  
  RESULTS
  TWA was negative in 28 Ath (65%), positive in 8 (19%) and indeterminate in 7 (16%). All subjects with negative TWA did not show induction of VT at EES, with significant correlation between negative TWA and negative EES (p<0.001). All Ath with positive TWA also had VT induced by a EES, but without significant correlation between positive TWA and positive EES. In 2 Ath with undetermined TWA (29%) VT were induced at EES. Our data did not show significant correlation between indeterminate TWA and positive or negative EES. However, logistic regression analysis showed significant correlation between abnormal TWA test (positive or indeterminate) and inducibility of VT at EES (p<0.001). During follow-up we observed a significant difference in end-point occurrence between Ath with negative or positive TWA and between Ath with negative or positive EES.
  
  
  CONCLUSIONS
  TWA confirm its role as a simple and non-invasive test, and it seems useful for prognostic stratification of Ath with VA.
authors: Department of Cardiology, Ospedale Maggiore, Crema - Italy.
authors: Giuseppe
authors: G
authors: Inama
authors: Claudio
authors: C
authors: Pedrinazzi
authors: Ornella
authors: O
authors: Durin
authors: Massimiliano
authors: M
authors: Nanetti
authors: Giorgio
authors: G
authors: Donato
authors: Rita
authors: R
authors: Pizzi