Determinant of microvolt-level T-wave alternans in patients with dilated cardiomyopathy

Adachi, Kazumasa; Ohnishi, Yozo; Shima, Takashi; Yamashiro, Kouhei; Takei, Atsushi; Tamura, Nami; Yokoyama, Mitsuhiro

doi:10.1016/s0735-1097(99)00208-9

Cited by 84 publications

(49 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The presence of microvolt-level TWA, measured using the spectral method during bicycle exercise testing, has been reported to be associated with an increased risk of ventricular arrhythmias in several clinical settings, [13][14][15][16][17] and we have reported its clinical usefulness in identifying patients at risk after acute MI. 16 Recently, Klingenheben et al 17 reported that TWA was independently associated with arrhythmic events in congestive heart failure, whereas other noninvasive markers, including LP, were not.…”

Section: Twa and Arrhythmiamentioning

confidence: 89%

Clinical Usefulness of the Combination of T-Wave Alternans and Late Potentials for Identifying High-Risk Patients With Moderately or Severely Impaired Left Ventricular Function

et al. 2001

View full text Add to dashboard Cite

Section: Twa and Arrhythmiamentioning

confidence: 89%

Clinical Usefulness of the Combination of T-Wave Alternans and Late Potentials for Identifying High-Risk Patients With Moderately or Severely Impaired Left Ventricular Function

et al. 2001

View full text Add to dashboard Cite

“…3-5, 9, 10) Although Adachi, et al 9) have reported that the presence of TWA is significantly associated with VT in patients with DCM, no studies have documented this result prospectively. Recently, Klingenheben, et al 10) reported the usefulness of TWA in the setting of congestive heart failure including use of antiarrhythmic drugs.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] However, little information is available regarding the clinical significance of TWA and QTD in the setting of DCM. [9][10][11][12] Moreover, these markers have not been prospectively compared to each other for patients with DCM. In the present study, we prospectively compared the clinical significance of TWA and QTD to identify patients at risk for ventricular tachyarrhythmias (VTs) in the setting of DCM.…”

mentioning

confidence: 99%

Comparison of T-Wave Alternans and QT interval Dispersion to Predict Ventricular Tachyarrhythmia in Patients with Dilated Cardiomyopathy and without Antiarrhythmic Drugs.

et al. 2001

View full text Add to dashboard Cite

SUMMARYMicrovolt T-wave alternans (TWA) and QT interval dispersion (QTD), which reflect temporal and spatial repolarization abnormalities, respectively, have been proposed as useful indices to identify patients at risk for ventricular tachyarrhythmias (VTs). The purpose of this study was to clarify which repolarization abnormality marker is more useful in predicting arrhythmic events in patients with dilated cardiomyopathy (DCM).Forty-two consecutive nonischemic DCM patients underwent the assessment of TWA and QTD. Patients undergoing antiarrhythmic pharmacotherapy, except β-blockers and those with irregular basic rhythms, were excluded from entry. Eight patients were also excluded because of indeterminate test results. Therefore, 34 DCM patients were prospectively assessed. The end point of the study was the documentation of VT defined as ≥ 5 consecutive ectopic beats during the follow-up period.TWA and QTD (≥65 msec) were positive in 24 (80%) and 11 (37%) of 30 patients with available follow-up data, respectively. There was no relationship between TWA and QTD. During a follow-up of 13±11 months, VTs occurred in 13 patients (43%). In Cox regression analysis, TWA was a significant risk stratifier (p=0.02), whereas QTD was not. The sensitivity, specificity, and positive and negative predictive values of TWA in predicting VTs were 100%, 35%, 54%, and 100%, respectively.TWA could be a useful noninvasive index to identify patients at risk for VTs in the setting of DCM. This study may suggest that temporal repolarization abnormality is associated more with arrhythmogenesis than with spatial repolarization abnormality in DCM patients. (Jpn Heart J 2001; 42: 451-457)

show abstract

“…This study included patients with nonischemic dilated cardiomyopathy, and a number of other small studies have confirmed the prognostic significance of TWA in such patients. [42][43][44] An example of a positive TWA tracing in a patient with heart failure is shown in Figure 2.…”

Section: Clinical Studiesmentioning

confidence: 99%

Role of noninvasive studies in risk stratification for sudden cardiac death

Kunavarapu

Bloomfield

2004

Clinical Cardiology

View full text Add to dashboard Cite

Summary: Sudden cardiac death (SCD) is one of the leading causes of mortality in developing countries. To prevent SCD, it is crucial to have effective tools for identifying patients at risk, given that there are now effective devices and medications that can prevent SCD. Two noninvasive electrocardiographic tools have been approved by the Food and Drug Administration and are being used clinically for identifying patients at risk for SCD: the signal-averaged electrocardiogram (SAECG) and T-wave alternans (TWA). This article reviews each of these approaches and includes a discussion of the mechanisms and a summary of the clinical studies published to date.

show abstract

Determinant of microvolt-level T-wave alternans in patients with dilated cardiomyopathy

Abstract: T-wave alternans was closely related to VT in patients with DCM. T-wave alternans is a useful noninvasive test for identifying high risk patients with DCM who have VT.

Cited by 84 publications

References 28 publications

Clinical Usefulness of the Combination of T-Wave Alternans and Late Potentials for Identifying High-Risk Patients With Moderately or Severely Impaired Left Ventricular Function

Clinical Usefulness of the Combination of T-Wave Alternans and Late Potentials for Identifying High-Risk Patients With Moderately or Severely Impaired Left Ventricular Function

Comparison of T-Wave Alternans and QT interval Dispersion to Predict Ventricular Tachyarrhythmia in Patients with Dilated Cardiomyopathy and without Antiarrhythmic Drugs.

Role of noninvasive studies in risk stratification for sudden cardiac death

Contact Info

Product

Resources

About