MicroVolt T
Wave Alternans (MTWA-Spectral Method) Risk
Assessment of
Malignant Arrhythmias (introduction)
European News
Web Page
Editor: D. Marangoni Updated September 14, 2021
info@alternans.org
………………………………………………………………………………………………………………………..............
Marangoni Ravasi Interview
on Science
D.Marangoni Book
ESC
Congress 2016 in Review article: Prophylactic
use of ICD in patients with non ischemic heart
failure: results from the DANISH study. FAILED
Results
from the DANISH study [Křber L et al. N Engl J Med. 2016], failed to show a significant reduction
in all-cause mortality with the prophylactic use of implantable cardioverter
defibrillator (ICD) devices in patients with symptomatic systolic heart failure
(HF) not caused by coronary artery disease.
Microvolt
T-wave alternans profiles in patients with pulmonary arterial
hypertension compared to patients with left ventricular systolic dysfunction
and a group of healthy volunteers.
Improving
the appropriateness of sudden arrhythmic death primary prevention by
implantable cardioverter-defibrillator therapy in patients with low left ventricular
ejection fraction. Point of view. Full Text J Cardiovasc Med (Hagerstown). 2016
Apr
Heart Rhythm J:
Contemporary rates of appropriate shock therapy in patients who receive implantable
device therapy in a real-world setting: From the
Israeli ICD Registry: appropriate ICD shock
therapy at 30-month follow-up was 2.6%.These findings suggest a need for
improved risk stratification and patient selection in this population..
Remarks on polyparametric assessment of sudden death risk for primary
prevention ICD implantation in patients with left ventricular dysfunction of
ischemic and non ischemic etiology.
Italian Association of Hospital Cardiologists (ANMCO) Experts Position Paper.
Usefulness
of T-Wave Alternans to Distinguish Right Ventricular
Cardiomyopathy From Idiopathic Right Ventricular Outflow Tract Tachycardia.
Usefulness of
microvolt T-wave alternans testing in the assessment of all-cause
mortality and life-threatening ventricular arrhythmia risk in patients with
left ventricular dysfunction.
NEW MTWA Application
to detect ischemia:
-T-Wave Alternans Is Linked to
Microvascular Obstruction and to Recurrent Coronary Ischemia After Myocardial
Infarction.
- The value of microvolt T-wave
alternans in the diagnosis of reversible myocardial ischemia in patients
without structural
cardiac disease (First Prize
Dubrovnik Cardiology Highlights an ESC Update Programme)
Prospective
Use of Microvolt T-Wave Alternans Testing to Guide Primary Prevention
Implantable Cardioverter
Defibrillator
Therapy
Multicenter Study (650 patients with ICD implants based on
MTWA results in patients with EF< and > 35%) full test free
Circulation
Journal June 15 2015.
MTWA at
ISHNE Congress in Lyon - France
Microvolt T-wave
alternans in patients undergoing elective coronary artery bypass grafting: a
pilot study
Remarks
on the guideline recommendations for cardioverter-defibrillator implantation
for primary prevention of sudden cardiac Death in patients with severe
ventricular dysfunction. Consensus Document of the Italian Association of
Hospital Cardiologists (ANMCO)/Italian Society of Cardiology (SIC)/Italian
Association of Arrhythmology and Cardiac Pacing
(AIAC)
Medicare
Final Decision
The
Centers for Medicare & Medicaid Services has
decided that no National Coverage Determination (NCD) is appropriate at this
time for microvolt T-wave alternans (MTWA) testing using the modified moving
average (MMA) method for the evaluation of patients at risk for sudden cardiac
death (January 13, 2015)
Centers for Medicare and Medicaid Services - National Coverage Analyses: Microvolt T-wave
Alternans Posted proposed decision memo (October 23,2014):
MMA
METHOD again NOT approved. Only Spectral Analytic Method is reimbursed
Time
for a Change -- A New Approach to ICD Replacement
MTWA the best Sudden Death
predictor method in Dilated Cardiomiopathy: Circ Arrhythm Electrophysiol.
2014 Sep 27
Multiple Autonomic and
Repolarization Investigation of Sudden Cardiac Death in Dilated Cardiomyopathy
and Controls.
TWA
at ESC 2014
HRS 2014 abstract: “Reasons for Nonimplantation of Primary Prevention ICDs and Outcomes in
a Population of Patients with Left Ventricular Ejection Fractions of 35% or
Less” - Patients refusing ICD (8%) had a lower mortality than patients with ICD
implanted. Editor comment: MTWA can help in the decision not to implant up to
40% of the ICD patients
FULL TEXT of Clinical
use of microvolt T-wave alternans in patients with depressed left ventricular
function eligible for ICD implantation: mortality outcomes after long term
follow-up (International
Journal of Cardiology Volume 168, Issue 3, 3
October 2013, Pages 3038–3040)
ADVANCES CARDIAC ELECTROPHYSIOLOGY Symposium - ROME Italy November 21/22 2013: Time: 9:00 Sala Mancini Dr Molon presentation of the
published data on Clinical
use of microvolt T-wave alternans in patients with depressed left ventricular
function eligible for ICD implantation: mortality outcomes after long term
follow-up
A combined anatomic and
electrophysiologic substrate based approach for sudden cardiac death risk
stratification.( Am
Heart J. 2013 Oct)
The need to modify patient
selection to improve the benefits of implantable cardioverter-defibrillator for
primary prevention of sudden death in non-ischaemic dilated cardiomyopathy (Europace 2014 Aug. 14)
Powerpoint Presentation with comments of MTWA in ICD
Decision Making on International Journal of Cardiology Web Page
M T W Alternans on “Exercise Standards for Testing and Training: A
Scientific Statement From AHA”
Circulation.
2013;128:873-934. NEW: Extract
with reference to Alternans
Clinical use of microvolt T-wave alternans in
patients with depressed left ventricular function eligible for ICD
implantation: mortality outcomes after long term follow-up
International Journal of Cardiology, In Press, Corrected Proof, Available online 3 May 2013
Giulio Molon, Richard J. Cohen, Tiziana
de Santo, Alessandro Costa, Enrico Barbieri
Editor
Comments
HRS 2013: Disagreeing with an influential
thought leader on ICD use and ICDs, goals of care, and end of
life: Difficult conversations (Hyde Park talk at HRS 2013) (theHeart.org)
HRS 2013 MTWA useful and reliable
in ICD Decision Making:
-
PO06-99
- Microvolt T-wave Alternans Testing And Risk Of Death In Patients With And
Without ICDs Abstract
-
HRS
2013 MTWA in ICD Decision Making Poster
-
Editor Reminder: MTWA
Test Accurately Predicts Risk of sudden Cardiac Arrest in patients who do not already have implantable cardiac defibrillators
, Meta-Analysis Finds (Heart
Rhythm 2009;6:S36 –S44)
ICD
Decision making with MTWA: Negative result of
microvolt T-wave alternans test is helpful in scheduling the order of
cardioverter-defibrillator implantation in primary prevention of sudden cardiac
death in individuals with the left ventricular systolic dysfunction (Oct 2012)
AHA
2012: Microvolt T-wave Alternans in Adults with the Chosen Forms of Congenital
Heart
Disease
Microvolt T-wave alternans predicts cardiac
events after acute myocardial infarction in patients treated with primary
percutaneous coronary intervention
(Adv Med Sci 2012)
Another positive MTWA paper
(Sensitivity 100%) with detail analysis of
indeterminate tests: the proportion of
indeterminate MTWA results due to technical factors of no prognostic
significance, was small (5%). Kardiologia Polska
2012; 70, 8: 795–802
Sudden Cardiac Death and Implantable Cardioverter Defibrillators:
from Europace 2012
Case
Study: MTWA Identifies Latent Arrhythmic Risk in Hypertensive Cardiomyopathy