Microvolt T-Wave Alternans Identifies Patients With Ischemic Cardiomyopathy Who Benefit From Implantable Cardioverter-Defibrillator Therapy

Microvolt T-Wave Alternans Identifies Patients With Ischemic Cardiomyopathy Who Benefit From Implantable Cardioverter-Defibrillator Therapy Theodore Chow, Dean J. Kereiakes, Cheryl Bartone, Terri Booth, Edward J. Schloss, Theodore Waller, Eugene Chung, Santosh Menon, Brahmajee K. Nallamothu, Paul S....

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Published in:Journal of the American College of Cardiology 2007-01, Vol.49 (1), p.50-58
Main Authors: Chow, Theodore, MD, FACC, Kereiakes, Dean J., MD, FACC, Bartone, Cheryl, BS, Booth, Terri, RN, Schloss, Edward J., MD, FACC, Waller, Theodore, MD, FACC, Chung, Eugene, MD, Menon, Santosh, MD, Nallamothu, Brahmajee K., MD, MPH, Chan, Paul S., MD, MSc
Format: Article
Language:English
Subjects:
Aged
Arrhythmias, Cardiac
Biological and medical sciences
Cardiac arrhythmia
Cardiology
Cardiology. Vascular system
Cardiomyopathies - diagnosis
Cardiomyopathies - etiology
Cardiomyopathies - therapy
Cardiovascular
Defibrillators, Implantable
Drug therapy
Female
Heart
Heart attacks
Humans
Internal Medicine
Male
Medical sciences
Middle Aged
Mortality
Myocardial Ischemia - complications
Myocardial Ischemia - therapy
Myocarditis. Cardiomyopathies
Prospective Studies
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Summary:Microvolt T-Wave Alternans Identifies Patients With Ischemic Cardiomyopathy Who Benefit From Implantable Cardioverter-Defibrillator Therapy Theodore Chow, Dean J. Kereiakes, Cheryl Bartone, Terri Booth, Edward J. Schloss, Theodore Waller, Eugene Chung, Santosh Menon, Brahmajee K. Nallamothu, Paul S. Chan Microvolt T-wave alternans (MTWA) has been proposed as an effective tool for risk stratifying patients with ischemic cardiomyopathy, but no studies to date have evaluated whether the efficacy of implantable cardioverter-defibrillators (ICDs) differs by MTWA group. We prospectively followed up 768 patients with ischemic cardiomyopathy and no prior history of ventricular arrhythmia. Using multivariable Cox analyses, we found that ICDs reduced rates of all-cause and arrhythmic mortality in MTWA-non-negative (positive and indeterminate) patients but not in MTWA-negative patients. Our results suggest that risk stratification with MTWA may identify patients most and least likely to benefit from ICD therapy.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2006.06.079