Post-myocardial infarction arrhythmia risk stratification using microvolt T-wave alternans.
Since its initial description, a number of studies have described the use of microvolt T-wave alternans (MTWA) as a predictor of the primary or secondary occurrence of ventricular arrhythmic events. These studies, however, have been limited by small sample sizes and disparate patient populations. Studies of MTWA in post-myocardial infarction (MI) patients are few in number, but hold predictive value for risk of ventricular arrhythmias. We performed a study of MTWA in post-myocardial infarction patients to clarify the predictive accuracy and usefulness of MTWA compared to other invasive and non-invasive techniques. We enrolled 120 patients (74 men, 46 women, mean age 62.3 ± 15.2 years in men, and 64.2 ± 13.8 years in women) with a history of myocardial infarction but no prior sustained ventricular arrhythmias. Patients were assessed by echocardiography, Holter, signal averaged ECG, MTWA, and electrophysiology study. Mean follow-up was 14 months. The MTWA test had a good negative predictive value for arrhythmic events in post-MI patients and can be used for risk stratification. We consider that in patients with positive MTWA further invasive evaluation, respectively electrophysiology study, is necessary.
Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania.
I
I
Donoiu
Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania.
Oana Cristina
OC
Mirea
Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania.
Alina
A
Giuca
Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania.
C
C
Militaru
Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania.
D D
DD
Ionescu
T-wave alternans; risk stratification; sudden death; ventricular arrhythmias