CHSJ

Curr Health Sci J, vol. 38, no. 2, 2012

Post-Myocardial Infarction Arrhythmia Risk Stratification Using Microvolt T-Wave Alternans

[Original paper]

I. DONOIU(1), M.O. CRISTINA(1), A. GIUCA(1), C. MILITARU(1), D.D.IONESCU(1)


(1)Department of Cardiology, Craiova University of Medicine and Pharmacy, Romania


Abstract:

ince its initial description, a number of studies have described the use of microvolt T-wave alternans (MTWA) as a predictor of the primary or secondary occurrence of ventricular arrhythmic events. These studies, however, have been limited by small sample sizes and disparate patient populations. Studies of MTWA in post-myocardial infarction (MI) patients are few in number, but hold predictive value for risk of ventricular arrhythmias. We performed a study of MTWA in post-myocardial infarction patients to clarify the predictive accuracy and usefulness of MTWA compared to other invasive and non-invasive techniques. We enrolled 120 patients (74 men, 46 women, mean age 62.3 ± 15.2 years in men, and 64.2 ± 13.8 years in women) with a history of myocardial infarction but no prior sustained ventricular arrhythmias. Patients were assessed by echocardiography, Holter, signal averaged ECG, MTWA, and electrophysiology study. Mean follow-up was 14 months. The MTWA test had a good negative predictive value for arrhythmic events in post-MI patients and can be used for risk stratification. We consider that in patients with positive MTWA further invasive evaluation, respectively electrophysiology study, is necessary


Keywords: isk stratification, sudden death, T-wave alternans, ventricular arrhythmias



Corresponding: Donoiu Ionut, MD, PhD student, Teaching Assistant, Department of Cardiology, Craiova University of Medicine and Pharmacyof Craiova, Str Petru Rares nr. 4, 200456, RomAnia; mail: i.donoiu@gmail.com


DOI 10.12865/CHSJ.38.02.04 - Download PDF
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