THE COMBINATION OF T WAVE ALTERNANS AND HEART RATE VARIABILITY TO PROGNOSIS HEART FAILURE

2011 ◽  
pp. 52-61
Author(s):  
Anh Tien Hoang
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Ventricular Arrhythmias ◽  
Clinical Status ◽  
Treadmill Test ◽  
Positive Predict Value ◽  
Heart Failure Patients ◽  
T Wave ◽  
T Wave Alternans

Objectives: In reccent decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-tobedside foundation makes TWA a very plausible index of worsen of clinical status. Also with the heart rate variability. We research this study with 2 targets: 1. Prognosis value of TWA and HRV in heart failure. 2. Prognosis value of the combination of TWA and HRV in heart failure. Methods: Prospective study: 82 chronic heart failure patients were admitted to hospital from 2010 May to 2011 May and 50 healthy people were done treadmill test to caculate TWA, ECG, Holter ECG, echocardiography. Results: The combination of TWA and HRV to prognosic the worsen clinical status have the highest prognosis value with OR=102.13 (p<0.001) sensitivity: 80.49%, specificity: 98%, positive predict value: 98.51%, negative predict value: 75.38%. The combination of TWA and HRV to prognosic the ventricular arrythmia have the highest prognosis value with OR=46.25 (p<0.001) sensitivity: 83.33%, specificity: 90.24%, positive predict value: 89.74%, negative predict value: 84.09%. Conclusions: We should combine TWA and HRV in clinical to prognose heart failure patients.

Utility of heart rate turbulence and T‐wave alternans to assess risk for readmission and cardiac death in hospitalized heart failure patients

2018 ◽  
Vol 29 (9) ◽  
pp. 1257-1264 ◽  
Author(s):  
Shinya Yamada ◽  
Akiomi Yoshihisa ◽  
Yu Sato ◽  
Takamasa Sato ◽  
Masashi Kamioka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Cardiac Death ◽  
Heart Rate Turbulence ◽  
Heart Failure Patients ◽  
T Wave ◽  
T Wave Alternans

scholarly journals 136-02: Effect of Loss of Heart Rate Variability on T-wave Heterogeneity and QT Variability in Heart Failure Patients: Implications in Ventricular Arrhythmogenesis

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i89-i89
Author(s):  
Sachin Nayyar ◽  
Muhammad Hasan ◽  
Kurt Roberts-Thomson ◽  
Thomas Sullivan ◽  
Mathias Baumert
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Heart Failure Patients ◽  
T Wave ◽  
Qt Variability ◽  
Ventricular Arrhythmogenesis

scholarly journals Does exercise training affect heart rate variability (HRV) and microvolt T-wave alternans (TWA) in chronic heart failure

2000 ◽  
Vol 2 ◽  
pp. 65-65
Author(s):  
A. Deligiannis ◽  
E.K. Evangelia Kouidi ◽  
J. John Tahmatzidis ◽  
G.K. Georgia Koukouvou ◽  
G. L. George Louridas
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
T Wave ◽  
T Wave Alternans ◽  
Affect Heart Rate

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

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

P991Predicting arrhythmic risk in dilated cardiomyopathy: a systematic review & meta-analysis of clinical parameters

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Sammani ◽  
E Kayvanpour ◽  
L P Bosman ◽  
F Sedaghat-Hamedani ◽  
T Proctor ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Risk ◽  
Dilated Cardiomyopathy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Gadolinium Enhancement ◽  
T Wave ◽  
History Of ◽  
T Wave Alternans

Abstract Background Patients with non-ischemic dilated cardiomyopathy (NIDCM) are at increased risk of ventricular arrhythmias and sudden cardiac death (SCD). However, identifying patients at high risk for life-threatening ventricular arrhythmia (LTVA) who may benefit from an implantable cardioverter defibrillator (ICD) remains challenging. Methods We searched MEDLINE and EMBASE for prognostic studies describing predictors of LTVA (defined as sustained ventricular tachycardia (VT), haemodynamically unstable VT, ventricular fibrillation, (aborted) SCD or appropriate ICD intervention) in patients with NIDCM. We excluded articles with composite heart failure and arrhythmic endpoints but lacking (subgroup) analysis for LTVA. Study quality and risk of bias was assessed using the QUIPS-tool, and articles with high risk of bias in ≥2 areas were excluded from analysis. Univariable hazard ratios of reported predictors were pooled from the remaining studies in a meta-analysis using a random-effects model and presented with 95% confidence interval (CI). Results Out of 1996 unique citations, 51 studies were included comprising 9798 patients with 1493 arrhythmic events. 28 studies were pooled for meta-analysis (mean age 55±4.1 years, 72% male) with a mean follow-up of 3.7±1.9 years. Crude event rate was 4.3% (95% CI 4.02–4.57) per year. From our meta-analysis, hypertension (HR 1.95; CI [1.26–3.00]), history of out of hospital cardiac arrest or sustained VT (HR 4.15; CI [1.32–13.02]), T-wave alternans (HR 6.50; CI [2.46–17.14]), LVEDV per 10ml/m2 increase (HR 1.10; CI [1.10–1.10]), LVESV per 10ml/m2 increase (HR 1.10; CI [1.00–1.22]) and delayed gadolinium enhancement (HR 5.55; CI [4.02–7.67]) were significantly associated with LTVA (figure). The quality of evidence was moderate and there was significant heterogeneity (median i2 57%; IQR 76%) among studies. Additionally from data that could not be pooled, decreased LVEF, history of nsVT and decreased heart rate variability were significantly associated with LTVA. Summary of meta-analysis results Conclusion The risk of LTVA in NIDCM is 4.3% per year and is considerably higher in patients with hypertension, history of LTVA, decreased LVEF, high LVEDV, high LVESV, T-wave alternans, history of nsVT, decreased heart rate variability and delayed gadolinium enhancement. These results may help determine appropriate candidates for ICD implantation. The high heterogeneity in reported results indicate the need for future multicentre studies to further improve risk stratification in NIDCM. Acknowledgement/Funding ERA-CVD JTC2016: DETECTIN-HF, 680969 & Dutch Heart Foundation (2016T096)

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