T-wave alternans and dispersion of the QT interval as risk stratification markers in patients susceptible to sustained ventricular arrhythmias

1998 ◽  
Vol 82 (9) ◽  
pp. 1127-1129 ◽  
Author(s):  
Antonis A Armoundas ◽  
Motohisa Osaka ◽  
Theofanie Mela ◽  
David S Rosenbaum ◽  
Jeremy N Ruskin ◽  
...  
2007 ◽  
Vol 3 (1-2) ◽  
pp. 182618680700300 ◽  
Author(s):  
Giuseppe Inama ◽  
Claudio Pedrinazzi ◽  
Ornella Durin ◽  
Massimiliano Nanetti ◽  
Giorgio Donato ◽  
...  

2009 ◽  
Vol 3 (1) ◽  
Author(s):  
Giuseppe Inama ◽  
Claudio Pedrinazzi ◽  
Ornella Durin ◽  
Massimiliano Nanetti ◽  
Giorgio Donato ◽  
...  

2007 ◽  
Vol 3 (1) ◽  
Author(s):  
Giuseppe Inama ◽  
Claudio Pedrinazzi ◽  
Ornella Durin ◽  
Massimiliano Nanetti ◽  
Giorgio Donato ◽  
...  

2009 ◽  
Vol 3 (1) ◽  
Author(s):  
Giuseppe Inama ◽  
Claudio Pedrinazzi ◽  
Ornella Durin ◽  
Massimiliano Nanetti ◽  
Giorgio Donato ◽  
...  

2013 ◽  
pp. 178-89
Author(s):  
Reza Octavianus ◽  
Yoga Yuniadi ◽  
Budhi Setianto

Early repolarization described as J-point elevation with concaved ST segment, notch or slurred at terminal QRS complex on surface electrokardiography. This electrokardiography pattern that usually exists in young male population, for about 60 years has been concluded as benign normal variant electrokardiography. Klatsky in 2002, has strengthed this issues with his study with 1000 elecrokardiographies with early repolarization which were followed for 12 years. There was no significant case for hospitality or malignant ventricular arrhythmias among population with early repolarization comparared with normal elektrokardiography without early repolarization.But, recent studies with larger samples, show different thing, which is there was a correlation between early repolarization and malignat ventricular arrhythmias. So the issue is, whether we can still consider this early repolarization as a normal variant or not. And how about the management of asymptomatic population with early repolarization such as syncope or evidence of malignant ventricular arrhythmias.T-wave Alternans is a difference at amplitude or morphology of ST segment and T wave in every other heart beat. T-wave Alternans measurement is a non-invasive method to value cardiac cells hererogeneity. This examination has been proven to be useful as a risk stratification for malignant ventricular arrhythmias events in large studies. Higher T-wave Alternans value accompanied with higher risk for developing these arrythymias. T-wave Alternans measurement has been approved in the guideline for management of wide QRS complex tachyarrythmias for detection ventricular arrhythmias with I and IIa class of recommedantion. The more practical Modified Moving Average technicque which can be performed in healthy subjects with early repolarization is useful for risk stratification. Large studies have approved the use of Modified Moving Average for measure T-wave Alternans in these arrhythmias risk stratification.


2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone


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