Temporal variations in microvolt T-wave alternans testing after acute myocardial infarction.

摘要

We appreciate the interest of Dr. John Madias in our article and the perspective provided of the limitations currently observed in microvoltage T-wave alternans (TWA) assessment. We agree with most of the-comments with regard to appropriately interpreting the results of TWA. Nevertheless, a large number of authors demonstrated the role of TWA as a strong independent predictor of sudden cardiac death (SD) in diverse disease states based in the spectral analysis of the signal and qualitative assessment of TWA We would like to point out that, beyond changes in the electrophysiological status of the patients and potential problems with the re-producibility of the test, postinfarction ventricular remodeling and depressed left ventricle function can possibly contribute to modifications in TWA results.