Document Detail

Average T-wave alternans activity in ambulatory ECG records predicts sudden cardiac death in patients with chronic heart failure.
MedLine Citation:
PMID:  22024149     Owner:  NLM     Status:  Publisher    
BACKGROUND: T-wave alternans (TWA) is a well documented noninvasive ECG method useful for identifying patients at risk for sudden cardiac death (SCD). OBJECTIVE: The purpose of this study was to evaluate if the long-term average TWA activity on Holter monitoring provides prognostic information in patients with chronic heart failure (CHF). METHODS: Twenty-four-hour Holter ECGs from 650 ambulatory patients with mild-to-moderate CHF were analyzed in the study. Average TWA activity was measured using a fully-automated multilead technique, and two indices were proposed to quantify TWA: an index quantifying the average TWA activity in the whole recording (IAA), which was used to define a positive/negative TWA test, and an index quantifying the average TWA activity at heart rates between 80 and 90 bpm (IAA(90)). RESULTS: Patients were divided into TWA positive (TWA+) and TWA negative (TWA-) groups by setting a cut point for IAA of 3.7 μV, corresponding to the 75 (th) percentile of the distribution of IAA in the population. After a median follow-up of 48 months, survival rate was significantly higher in group TWA- for cardiac death (CD) and SCD ( p = 0.017 and p = 0.001 respectively). Multivariate Cox proportional hazards analysis revealed that both TWA+ and IAA(90) were associated with SCD with hazard rates of 2.29 ( p = 0.004) and 1.07 per μV ( p = 0.046) respectively. CONCLUSION: The average TWA activity automatically measured from Holter ECGs predicts SCD in patients with mild to moderate CHF.
Violeta Monasterio; Pablo Laguna; Iwona Cygankiewicz; Rafael Vázquez; Antoni Bayés-Genís; Antoni Bayés de Luna; Juan Pablo Martínez
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-21
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Aragon, Spain; Aragón Institute of Engineering Research, IIS Aragón, Universidad de Zaragoza, Aragon, Spain.
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