Editor: D. Marangoni Updated September 14, 2021
Results from the DANISH study [Køber 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.
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..
NEW MTWA Application to detect ischemia:
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)
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 ( 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
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)
M T W Alternans on “Exercise Standards for Testing and Training: A Scientific Statement From AHA”
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
HRS 2013 MTWA useful and reliable in ICD Decision Making:
- 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)
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
Sredniawa B, Kowalczyk J, Lenarczyk R, Kowalski O, Sędkowska A, Cebula S, Musialik Łydka A, Kalarus Z.
Kardiol Pol. 2012;70(5):447-455.
A Decisional Needs Assessment Related to Implantable Cardioverter-Defibrillators for the Primary Prevention of Sudden Cardiac Death (The Informed Medical Decisions Foundation): MTWA can help in Shared Decision Making
Reminder: MTWA risk assessment in Professional Athletes papers:
Role of Substrate and Triggers in the Genesis of Cardiac Alternans, From the Myocyte to the Whole Heart: Implications for Therapy Faisal M. Merchant and Antonis A. Armoundas ( Circulation 2012;125 539-549)
Predictive Value of Microvolt T-Wave Alternans for Cardiac Death or Ventricular Tachyarrhythmic Events in Ischemic and Nonischemic Cardiomyopathy Patients: A Meta-Analysis (on 5600 patients – ANE 2011)
PREVENT-SCD trial, presented at the American Heart Association Scientific Sessions in Orlando, Florida, reinforce the value of the Microvolt T-wave Alternans test in identifying patients at risk of sudden cardiac death (SCD).
NIH Sponsored Study in JACC Extends Predictive Ability of Microvolt T-Wave Alternans; Non-invasive study shown effective in identifying patients both at high and low risk of sudden cardiac death (J Am Coll Cardiol, 2006; 47:456-463)
ACC/AHA/ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Cardiac Death – Extracted Sections on T Wave Alternans in Class 2a (Level of Evidence A): All reference papers are based on the Spectral Analytic MethodC:\Users\pc\My Documents\WEBPAGE\ReviewKCL2002.pdfC:\Users\pc\My Documents\WEBPAGE\ReviewKCL2002.pdf