Why the study?
Does microvolt T-wave alternans testing predict cardiovascular mortality and sudden cardiac death in patients with reduced or preserved left ventricular function?
Does microvolt T-wave alternans testing predict cardiovascular mortality and sudden cardiac death in patients with reduced or preserved left ventricular function?
Microvolt T-wave alternans is associated with cardiovascular mortality and sudden cardiac death, but its clinical utility for guiding therapy remains unproven by randomized trials.
May support arrhythmia risk stratification; leaves open need for prospective trials on therapeutic guidance.
Microvolt T-wave alternans (TWA), characterised as beat-to-beat fluctuation of T-wave amplitude and morphology, is an electrophysiological phenomenon associated clinically with impending ventricular arrhythmias and is an important marker of arrhythmia risk. Currently, two main methods for the detection of TWA exist, namely, the spectral method and the time-domain modified moving average method; both are discussed in this review. Microvolt TWA has been associated with cardiovascular mortality and sudden cardiac death in several clinical studies involving >14,000 subjects with reduced as well as preserved left ventricular function. Although TWA appears to be a useful marker of susceptibility for lethal ventricular arrhythmias and cardiovascular death, so far there is no sufficient evidence from randomised clinical trials to support its use in guiding therapy. However, several ongoing trials are expected to provide more information about the clinical use of TWA testing.
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Aro et al. (2016) studied this question.
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