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Cited by 201Cardiac pacing and defibrillation studiesCardiac electrophysiology and arrhythmiasCardiac Arrhythmias and Treatments

The DOI matches its Crossref record; 29 of the 30 references it cites were found in a registry or an index.

Does Microvolt T-Wave Alternans Testing Predict Ventricular Tachyarrhythmias in Patients With Ischemic Cardiomyopathy and Prophylactic Defibrillators?

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Chow, Theodore, Kereiakes, Dean J., Onufer, John, Woelfel, Alan, Gursoy, Sinan, Peterson, Brett J., Brown, Mark L., Pu, Wenji, Benditt, David G.·2008·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2008.08.018
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Abstract

Objectives The purpose of this trial was to determine whether microvolt T-wave alternans (MTWA) predicts ventricular tachyarrhythmic events (VTEs) in post-myocardial infarction patients with left ventricular ejection fraction (LVEF) < or =30%.Background Previous studies have established MTWA as a predictor for total and arrhythmic mortality, but its ability to identify prophylactic implantable cardioverter-defibrillator (ICD) recipients most likely to experience VTEs remains uncertain.Methods This prospective trial was conducted at 50 U.S. centers. Patients were eligible if they met MADIT-II (Multicenter Automatic Defibrillator Implantation Trial II) indications for device implant. All patients underwent MTWA testing followed by ICD implantation, with pre-specified programming to minimize the likelihood of therapies for non-life-threatening VTE. Minimum follow-up was 2 years with annual MTWA testing. Initially indeterminate MTWA tests were repeated.Results Analyses were conducted on 575 patients (84% male; average age +/- SD = 65 +/- 11 years; average LVEF +/- SD = 0.24 +/- 0.05). The final distribution of MTWA results were: MTWA positive in 293 (51%), MTWA negative in 214 (37%), and indeterminate in 68 patients (12%). Over an average follow-up of 2.1 +/- 0.9 years, there were 70 VTEs. A VTE occurred in 48 of 361 (13%, 6.3%/year) MTWA non-negative and 22 of 214 (10%, 5.0%/year) MTWA negative patients. A non-negative MTWA test result was not associated with VTE (hazard ratio: 1.26; 95% confidence interval: 0.76 to 2.09; p = 0.37), although total mortality was significantly increased (hazard ratio: 2.04; 95% confidence interval: 1.10 to 3.78; p = 0.02).Conclusions In MADIT-II-indicated ICD-treated patients, the risk of VTE does not differ according to MTWA classification, despite differences in total mortality. (MASTER I-Microvolt T Wave Alternans Testing for Risk Stratification of Post MI Patients; NCT00305240).

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Research works printed but not linked: 2

  1. Gold, 2006, T-wave alternans SCD HeFT study: primary endpoint analysis, Circulation, 114, II428
  2. Costantini, 2006, The Alternans Before Cardioverter Defibrillator (ABCD) Trial: a noninvasive strategy for primary prevention of sudden cardiac death using T-wave alternans, Circulation, 114, 2426

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Metadata

Authors
Chow, T., Kereiakes, D. J., Onufer, J., Woelfel, A., Gursoy, S., Peterson, B. J., Brown, M. L., Pu, W., & Benditt, D. G.
Affiliations
  • Christ Hospital (US)
  • Medtronic (United States) (US)
  • University of Minnesota (US)
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2008-11
Volume
52
Issue
20
Pages
1607-1615
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2008.08.018
OpenAlex
W84927980
Cited by
201
References
30
Citations by year
2024: 3 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 11 · 2017: 12 · 2016: 10 · 2015: 12 · 2014: 11 · 2013: 21 · 2012: 23
FWCI
18.68
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Medtronic
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Keywords
microvolt T-wave alternans, ventricular tachyarrhythmia, ischemic cardiomyopathy, implantable cardioverter-defibrillator, MADIT II, myocardial infarction, left ventricular ejection fraction, arrhythmia risk prediction, all-cause mortality
MeSH terms
Aged, Female, Heart Function Tests, Humans, Male, Middle Aged, Cardiomyopathies, Prospective Studies, Defibrillators, Implantable, Tachycardia, Ventricular, Myocardial Ischemia

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