This study hypothesized that microvolt T-wave alternans (MTWA) improves selection of patients for implantable cardioverter-defibrillator (ICD) prophylaxis, especially by identifying patients who are not likely to benefit. Many patients with left ventricular dysfunction are now eligible for prophylactic ICDs, but most eligible patients do not benefit; MTWA testing has been proposed to improve patient selection. Our study was conducted at 11 clinical centers in the U.S. Patients were eligible if they had a left ventricular ejection fraction (LVEF) < or =0.40 and lacked a history of sustained ventricular arrhythmias; patients were excluded for atrial fibrillation, unstable coronary artery disease, or New York Heart Association functional class IV heart failure. Participants underwent an MTWA test and then were followed for about two years. The primary outcome was all-cause mortality or non-fatal sustained ventricular arrhythmias. Ischemic heart disease was present in 49%, mean LVEF was 0.25, and 66% had an abnormal MTWA test. During 20 +/- 6 months of follow-up, 51 end points (40 deaths and 11 non-fatal sustained ventricular arrhythmias) occurred. Comparing patients with normal and abnormal MTWA tests, the hazard ratio for the pri...Continue Reading
Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators
A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias
T wave alternans as a predictor of recurrent ventricular tachyarrhythmias in ICD recipients: prospective comparison with conventional risk markers
Quality-of-life six months after CABG surgery in patients randomized to ICD versus no ICD therapy: findings from the CABG Patch Trial
A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators
Predictive value of T-wave alternans for arrhythmic events in patients with congestive heart failure
Canadian Implantable Defibrillator Study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone
A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification
Onset heart rate of microvolt-level T-wave alternans provides clinical and prognostic value in nonischemic dilated cardiomyopathy
Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks
Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction
ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines)
Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy: results from a prospective observational study
T-wave alternans negative coronary patients with low ejection and benefit from defibrillator implantation
Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy: results of the Marburg Cardiomyopathy Study
Novel algorithm for identifying T-wave current density alternans using synthesized 187-channel vector-projected body surface mapping
Prognostic utility of T-wave alternans in a real-world population of patients with left ventricular dysfunction: the PREVENT-SCD study
SCD in patients with cardiomyopathy: use of microvolt T-wave alternans and other noninvasive tests for risk stratification and prevention of SCD
Treatment options for patients with coronary artery disease identified as high risk by T-wave alternans testing
Risk stratification of patients with prior myocardial infarction and advanced left ventricular dysfunction by gated myocardial perfusion SPECT imaging
Microvolt T-wave alternans and the selective use of implantable cardioverter defibrillators for primary prevention: a cost-effectiveness study
Microvolt T-wave alternans: an effective approach to risk stratification in ischemic cardiomyopathy?
Improved Stratification of Autonomic Regulation for risk prediction in post-infarction patients with preserved left ventricular function (ISAR-Risk)
Computational cardiology: how computer simulations could be used to develop new therapies and advance existing ones
The need to modify patient selection to improve the benefits of implantable cardioverter-defibrillator for primary prevention of sudden death in non-ischaemic dilated cardiomyopathy
Crescendo in depolarization and repolarization heterogeneity heralds development of ventricular tachycardia in hospitalized patients with decompensated heart failure
Microvolt T-wave alternans as a predictor of mortality and severe arrhythmias in patients with left-ventricular dysfunction: a systematic review and meta-analysis
Defibillator electrogram T wave alternans as a predictor of spontaneous ventricular tachyarrhythmias in defibrillator recipients
T-wave alternans and left ventricular wall thickness in predicting arrhythmic risk in patients with hypertrophic cardiomyopathy
Do optimal prognostic thresholds in continuous physiological variables really exist? Analysis of origin of apparent thresholds, with systematic review for peak oxygen consumption, ejection fraction and BNP
Microvolt T-wave alternans in end-stage renal disease patients--associations with uremic cardiomyopathy
Correlation between T-Wave Alternans and Cardiac Volume Status via Intrathoracic Impedance Measurements
Prognostic value of microvolt T-wave alternans in a real-world ICD population. Twente ICD Cohort Studie (TICS)
Distinguishing Right Ventricular Cardiomyopathy From Idiopathic Right Ventricular Outflow Tract Tachycardia with T-wave Alternans
Rate-dependent force, intracellular calcium, and action potential voltage alternans are modulated by sarcomere length and heart failure induced-remodeling of thin filament regulation in human heart failure: A myocyte modeling study
Clinical utility of microvolt T-wave alternans testing in identifying patients at high or low risk of sudden cardiac death
Prediction of sudden cardiac death in patients after acute myocardial infarction using T-wave alternans: a prospective study
Automatic microvolt T-wave alternans identification in relation to ECG interferences surviving preprocessing
Microvolt T-wave alternans and electrophysiologic testing predict distinct arrhythmia substrates: implications for identifying patients at risk for sudden cardiac death
Microvolt T-wave alternans, peak oxygen consumption, and outcome in patients with severely impaired left ventricular systolic function
Body surface projection of action potential duration alternans: a combined clinical-modeling study with implications for improving T-wave alternans detection
Time-domain T-wave alternans measured from Holter electrocardiograms predicts cardiac mortality in patients with left ventricular dysfunction: a prospective study
T-wave alternans in risk stratification of patients with nonischemic dilated cardiomyopathy: can it help to better select candidates for ICD implantation?
Assessment and key targets for therapy in the post-myocardial infarction patient with left ventricular dysfunction
Prognostic significance of inverse spatial QRS-T angle circadian pattern in myocardial infarction survivors
The link between repolarisation alternans and ventricular arrhythmia: does the cellular phenomenon extend to the clinical problem?
Intracardiac alternans compared to surface T-wave alternans as a predictor of ventricular arrhythmias in humans
Effect of bundle branch block on microvolt T-wave alternans and electrophysiologic testing in patients with ischemic cardiomyopathy
Combined prognostic value of peak O(2) uptake and microvolt level T-wave alternans in patients with idiopathic dilated cardiomyopathy
Microvolt t-wave alternans with exercise in pediatrics and congenital heart disease: limitations and predictive value
Microvolt T-wave alternans for risk stratification in athletes with ventricular arrhythmias: correlation with programmed ventricular stimulation
T-wave alternans: reviewing the clinical performance, understanding limitations, characterizing methodologies
Effect of noise on T-wave alternans measurement in ambulatory ECGs using modified moving average versus spectral method
Relationship between abnormal microvolt T-wave alternans and poor glycemic control in type 2 diabetic patients
Predicting arrhythmia-free survival using spectral and modified-moving average analyses of T-wave alternans
Relationship between ventricular dyssynchrony and T-wave alternans in patients with coronary artery disease
Sinus rhythm ECG criteria associated with basal-lateral ventricular tachycardia substrate in patients with nonischemic cardiomyopathy
T-wave alternans and ST depression assessment identifies low risk individuals with ischemic cardiomyopathy in the absence of left ventricular hypertrophy
T-wave alternans testing in pacemaker patients: comparison of pacing modes and long-term prognostic relevance
Spectral microvolt T-wave alternans testing has no prognostic value in patients recently hospitalized with decompensated heart failure
Prediction values of T wave alternans for sudden cardiac death in patients with chronic heart failure: a brief review
Do Beta-blockers impact microvolt T-wave alternans testing in patients at risk for ventricular arrhythmias? A meta-analysis
A class of Monte-Carlo-based statistical algorithms for efficient detection of repolarization alternans
Effect of oral beta-blocker therapy on microvolt T-wave alternans and electrophysiology testing in patients with ischemic cardiomyopathy
Individualizing decisions for patients with prophylactic implantable cardiac defibrillators subject to device advisories: a commentary
Reproducibility of the T-wave alternans and dependence of T-wave alternans on the T-wave amplitude: 2 issues requiring immediate attention
PACES/HRS expert consensus statement on the evaluation and management of ventricular arrhythmias in the child with a structurally normal heart
Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death
Late gadolinium enhancement of cardiac magnetic resonance imaging indicates abnormalities of time-domain T-wave alternans in hypertrophic cardiomyopathy with ventricular tachycardia
"Indeterminate" microvolt T-wave alternans tests predict high risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction
Microvolt T-wave alternans physiological basis, methods of measurement, and clinical utility--consensus guideline by International Society for Holter and Noninvasive Electrocardiology
Assessment of myocardial scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
Predictive value of microvolt T-wave alternans for sudden cardiac death in patients with preserved cardiac function after acute myocardial infarction: results of a collaborative cohort study
Arrhythmia risk prediction in patients with preserved left ventricular function: the final frontier?
Risk stratification for primary implantation of a cardioverter-defibrillator in patients with ischemic left ventricular dysfunction
Prognostic value of T-wave alternans in patients with heart failure due to nonischemic cardiomyopathy: results of the ALPHA Study
Ventricular repolarization dynamicity provides independent prognostic information toward major arrhythmic events in patients with idiopathic dilated cardiomyopathy
American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention
Endocardial and epicardial repolarization alternans in human cardiomyopathy: evidence for spatiotemporal heterogeneity and correlation with body surface T-wave alternans
Post-exercise assessment of cardiac repolarization alternans in patients with coronary artery disease using the modified moving average method
Microvolt T-wave alternans for arrhythmia risk stratification in left ventricular dysfunction: which patients benefit?
American Heart Association/american College of Cardiology Foundation/heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention
A combined anatomic and electrophysiologic substrate based approach for sudden cardiac death risk stratification
Ability of microvolt T-wave alternans to modify risk assessment of ventricular tachyarrhythmic events: a meta-analysis
Effects of exercise rehabilitation on cardiac electrical instability assessed by T-wave alternans during ambulatory electrocardiogram monitoring in coronary artery disease patients without and with diabetes mellitus
A novel cardiovascular risk stratification model incorporating ECG and heart rate variability for patients presenting to the emergency department with chest pain
Microvolt T-wave alternans amplifies spatial dispersion of repolarization in human subjects with ischemic cardiomyopathy
Usefulness of microvolt T-wave alternans for predicting outcome in patients with Chagas disease with implantable cardioverter defibrillators
Does manual T-wave window adjustment affect microvolt T-wave alternans results in patients with structural heart disease?
Impaired exercise capacity predicts sudden cardiac death in a low-risk population: enhanced specificity with heightened T-wave alternans
Microvolt T-wave alternans and autonomic nervous system parameters can be helpful in the identification of low-arrhythmic risk patients with ischemic left ventricular systolic dysfunction
Relationship between early diastolic dysfunction and abnormal microvolt T-wave alternans in patients with type 2 diabetes
Early repolarization associated with ventricular arrhythmias in patients with chronic coronary artery disease
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart
Structural heterogeneity alone is a sufficient substrate for dynamic instability and altered restitution
Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Utility of microvolt T-wave alternans to predict sudden cardiac death in patients with cardiomyopathy
Implantable cardioverter defibrillator therapy for patients with less severe left ventricular dysfunction
Steeper restitution slopes across right ventricular endocardium in patients with cardiomyopathy at high risk of ventricular arrhythmias
Microvolt QRS Alternans Without Microvolt T-Wave Alternans in Human Cardiomyopathy: A Novel Risk Marker of Late Ventricular Arrhythmias.
Predictive value of microvolt T-wave alternans for cardiac death or ventricular tachyarrhythmic events in ischemic and nonischemic cardiomyopathy patients: a meta-analysis
LifeMap: towards the development of a new technology in sudden cardiac death risk stratification for clinical use
A translational approach to probe the proarrhythmic potential of cardiac alternans: a reversible overture to arrhythmogenesis?
Antiarrhythmic Agents: Mechanisms of Action
Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.
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