Several clinical parameters and noninvasive tests have been developed to identify patients under the risk for sudden cardiac death (SCD). The microvolt T-wave alternans (MTWA) test is a noninvasive diagnostic method based on the measurement of subtle (microvolt) beat-to-beat alternation of the T-wave on the surface electrocardiogram and used for risk stratification of patients under the risk for SCD. Studies in the last decade have shown that the MTWA test is an effective method to distinguish patients with a high risk for arrhythmogenic mortality among patients suffering ischemic or nonischemic cardiomyopathies or with a history of myocardial infarction, with a high negative predictive value. This review revisits the MTWA test in the light of the most recent clinical studies.
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Arq Bras Cardiol
September 2023
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Background: Sudden cardiac death (SCD) resulting from ventricular arrhythmia is the main complication of hypertrophic cardiomyopathy (HCM). Microvolt T-wave alternans (MTWA) is associated with the occurrence of ventricular arrhythmias in several heart diseases, but its role in HCM remains uncertain.
Objective: To evaluate the association of MTWA with the occurrence of SCD or potentially fatal ventricular arrhythmias in HCM patients in a long-term follow-up.
Clin Auton Res
February 2023
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan 101, 1090, Brussels, Belgium.
Purpose: Drug-induced type I Brugada syndrome (BrS) is associated with a ventricular arrhythmia (VA) rate of 1 case per 100 person-years. This study aims to evaluate changes in electrocardiographic (ECG) parameters such as microvolt T wave alternans (mTWA) and heart rate variability (HRV) at baseline and during ajmaline testing for BrS diagnosis.
Methods: Consecutive patients diagnosed with BrS during ajmaline testing with 5-year follow-up were included in this study.
Ann Noninvasive Electrocardiol
November 2020
Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Background: Noninvasive risk stratification aims to detect abnormalities in the pathophysiological mechanisms underlying ventricular arrhythmias. We studied the predictive value of repeating risk stratification in patients with an implantable cardioverter-defibrillator (ICD).
Methods: The EUTrigTreat clinical study was a prospective multicenter trial including ischemic and nonischemic cardiomyopathies and arrhythmogenic heart disease.
Chin Med J (Engl)
June 2019
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Background: The long-term predicted value of microvolt T-wave alternans (MTWA) for ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains unclear. Our study explored the characteristics of MTWA and its prognostic value when combined with an electrophysiologic study (EPS) in patients with ARVC.
Methods: All patients underwent non-invasive MTWA examination with modified moving average (MMA) analysis and an EPS.
Ann Noninvasive Electrocardiol
March 2019
University of Zagreb, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia.
Aims: Microvolt T-wave alternans (MTWA) testing is a beat-to-beat fluctuation in the amplitude of T wave. We investigated whether: (a) MTWA can be new non-invasive tool for detection of reversible ischemia in patients with suspected CAD without structural heart disease, (b) MTWA can detect ischemia earlier and with greater test accuracy compared with exercise ECG ST-segment testing, and (c) threshold value of MTWA and heart rate at which the alternans is estimated can be different compared to standard values.
Methods: A total of 101 patients with suspected stable coronary disease, but without structural heart disease, were included.
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