| Microvolt T-wave alternans during exercise and pacing are not comparable. | |
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MedLine Citation:
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PMID: 19758980 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: The absence of microvolt T-wave alternans (MTWA) identifies a group of patients who are at low risk for ventricular arrhythmia or sudden cardiac death. However, in exercised assessed MTWA, 20-40% of all test results are indeterminate. We hypothesised that MTWA during pacing would yield less indeterminate results. METHODS AND RESULTS: Thirty patients with ischaemic cardiomyopathy and prior dual chamber implantable cardioverter defibrillator implantation were enrolled. All patients underwent sequential MTWA testing using an exercise (E), atrial-paced (A), and atrioventricular-paced (AV) protocol. The number of indeterminate tests was lower during pacing (A: 17%; AV: 3%) compared with exercise (37%) (E vs. A: P = 0.015, E vs. AV: P = <0.001). When positive and indeterminate test results were grouped as non-negative, the concordance rates between E and A, E and AV, and A and AV were 60% (kappa = 0.17), 57% (kappa = 0.058), and 70% (kappa = 0.348), respectively. If indeterminate results were excluded, agreements were 60% (kappa = 0.19), 50% (kappa = 0.129) and 67% (kappa = 0.33), respectively. CONCLUSION: Indeterminate test results are less common during pacing. However, there is a low concordance rate between test results using different protocols. This necessitates further study to determine the predictive value of each method in high risk patients with ischaemic cardiomyopathy. |
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Authors:
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Karin Kraaier; Patrick M J Verhorst; Job van der Palen; Pascal F H M van Dessel; Arthur A M Wilde; Marcoen F Scholten |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-09-15 |
Journal Detail:
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Title: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology Volume: 11 ISSN: 1532-2092 ISO Abbreviation: Europace Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-02 Completed Date: 2010-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883649 Medline TA: Europace Country: England |
Other Details:
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Languages: eng Pagination: 1375-80 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Haaksbergerstraat 55, 7513 ER Enschede, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Pacing, Artificial
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methods* Cardiomyopathies / complications, diagnosis* Electrocardiography / methods* Exercise Test / methods* Female Humans Male Middle Aged Myocardial Ischemia / complications, diagnosis* Reproducibility of Results Sensitivity and Specificity |
| Comments/Corrections | |
Comment In:
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Europace. 2010 Jan;12(1):146; author reply 146-7
[PMID:
20008497
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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