Can microvolt T-wave alternans predict mortality in patients with ischemic cardiomyopathy?

摘要

Microvolt T-wave alternans (MTWA) could be used to identify which patients who have ischemic cardiomyopathy and at high risk of sudden cardiac death would benefit from an implantable cardioverter-defibrillator (ICD). Further investigation is needed, as previous trials examining the prognostic utility of MTWA were not adjusted for baseline differences in age and left ventricular ejection fraction (LVEF). OBJECTIVE To find out whether mortality is predicted by MTWA in patients with ischemic cardiomyopathy. DESIGN This multicenter study prospectively enrolled consecutive patients undergoing MTWA testing who had a LVEF of 35% or less, and ischemic heart disease (i.e. diagnosed myocardial infarction, previous coronary revascularization or at least 70% diameter stenosis in one or more coronary vessels). Patients had to be in sinus rhythm during MTWA testing. Exclusion criteria included age less than 21 years and a history of ventricular arrhythmia.