Document Detail

Ambulatory ECG-based T-wave alternans and heart rate turbulence predict high risk of arrhythmic events in patients with old myocardial infarction.
MedLine Citation:
PMID:  19838004     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Few studies have explored risk stratification of arrhythmic events in patients with ischemic heart diseases according to T-wave alternans (TWA) using modified moving average (MMA) method and heart rate turbulence (HRT).
METHODS AND RESULTS: A retrospective analysis of 63 patients who underwent MMA-based TWA and HRT divided the patients into 3 groups: group-C of 21 controls, group-O of 21 patients with old myocardial infarction (OMI) showing no episodes of sustained ventricular tachyarrhythmia (SVT), and group-V of 21 OMI patients with episodes of SVT who received an implantable cardioverter-defibrillator. Among the 3 groups, positive TWA (>or=65 microV) and impaired HRT were observed most frequently in group-V (P<0.05). Using a logistic regression model, TWA yielded an odds ratio of 4.9 (95% confidence interval: 1.2-19.6, P<0.05), which was the only significant covariate for the incidence of life-threatening ventricular arrhythmias during a mean follow-up of 72 months.
CONCLUSIONS: Patients with OMI showing episodes of SVT have a high risk for cardiac death because of abnormal repolarization and autonomic regulation. The analysis of MMA-based TWA and HRT can be a useful tool for predicting OMI patients at high risk of arrhythmic events.
Shingo Maeda; Mitsuhiro Nishizaki; Noriyoshi Yamawake; Takashi Ashikaga; Hiroshi Shimada; Mitsutoshi Asano; Kensuke Ihara; Tadashi Murai; Hidetoshi Suzuki; Hiroyuki Fujii; Harumizu Sakurada; Masayasu Hiraoka; Mitsuaki Isobe
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Publication Detail:
Type:  Journal Article     Date:  2009-10-17
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-26     Completed Date:  2010-01-28     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2223-8     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Death, Sudden, Cardiac / etiology*,  prevention & control
Defibrillators, Implantable
Electrocardiography, Ambulatory*
Heart Conduction System / physiopathology*
Heart Rate*
Logistic Models
Middle Aged
Myocardial Infarction / complications*,  mortality,  physiopathology
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Tachycardia, Ventricular / diagnosis*,  etiology,  mortality,  physiopathology,  therapy
Time Factors
Ventricular Fibrillation / diagnosis*,  etiology,  mortality,  physiopathology,  therapy
Comment In:
Circ J. 2010 Mar;74(3):594; author reply 595   [PMID:  20081318 ]

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