Enhanced predictive power of quantitative TWA during routine exercise testing in the Finnish Cardiovascular Study

Journal of Cardiovascular Electrophysiology

Volumn 20, Issue 4, 2009, Pages 408-415

  Minkkinen, Mikko ^a   Kähönen, Mika ^b   Viik, Jari ^a   Nikus, Kjell ^b   Lehtimäki, Terho ^a,b   Lehtinen, Rami ^b,c   Kööbi, Tiit ^b   Turjanmaa, Väinö ^b   Kaiser, Willi ^d   Verrier, Richard L ^e   Nieminen, Tuomo ^a,f  

^a TAMPERE UNIVERSITY OF TECHNOLOGY   (Finland)

^b TAMPERE UNIVERSITY HOSPITAL   (Finland)

^c University of Applied Sciences   (Finland)

^d GE HEALTHCARE   (Germany)

^e HARVARD MEDICAL SCHOOL   (United States)

^f PÄIJÄT HÄME CENTRAL HOSPITAL   (Finland)

Author keywords

Electrocardiography; Sudden cardiac death; T wave alternans; Ventricular tachycardia

Indexed keywords

ADULT; ARTICLE; BICYCLE ERGOMETRY; CONTROLLED STUDY; ELECTROCARDIOGRAM; EXERCISE TEST; FEMALE; HEART ARRHYTHMIA; HEART HEMODYNAMICS; HUMAN; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MALE; MORTALITY; PRIORITY JOURNAL; PROGNOSIS; SUDDEN DEATH; T WAVE;

ADULT; AGED; ALGORITHMS; CARDIOVASCULAR DISEASES; DEATH, SUDDEN, CARDIAC; ELECTROCARDIOGRAPHY; EXERCISE TEST; FEMALE; FINLAND; HEART RATE; HUMANS; MALE; MIDDLE AGED; PREDICTIVE VALUE OF TESTS; PROPORTIONAL HAZARDS MODELS; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS;

EID: 63049107651     PISSN: 10453873     EISSN: 15408167     Source Type: Journal    
DOI: 10.1111/j.1540-8167.2008.01325.x     Document Type: Article

References (39)

1. Gehi AK, Stein RH, Metz LD, Gomes JA : Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events: A meta-analysis. J Am Coll Cardiol 2005 46 : 75 82.
2. Kaufman ES, Bloomfield DM, Steinman RC, Namerow PB, Costantini O, Cohen RJ, Bigger JT Jr. : "Indeterminate" microvolt T-wave alternans tests predict high risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction. J Am Coll Cardiol 2006 48 : 1399 1404.
3. Rosenbaum DS, Jackson LE, Smith JM, Garan H, Ruskin JN, Cohen RJ : Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med 1994 330 : 235 241.
4. Narayan SM : T-wave alternans and the susceptibility to ventricular arrhythmias. J Am Coll Cardiol 2006 47 : 269 281.
5. Klingenheben T, Ptaszynski P, Hohnloser SH : Quantitative assessment of microvolt T-wave alternans in patients with congestive heart failure. J Cardiovasc Electrophysiol 2005 16 : 620 624.
6. Nearing BD, Huang AH, Verrier RL : Dynamic tracking of cardiac vulnerability by complex demodulation of the T wave. Science 1991 252 : 437 440.
7. Nearing BD, Oesterle SN, Verrier RL : Quantification of ischaemia induced vulnerability by precordial T wave alternans analysis in dog and human. Cardiovasc Res 1994 28 : 1440 1449.
8. Nearing BD, Verrier RL : Progressive increases in complexity of T-wave oscillations herald ischemia-induced ventricular fibrillation. Circ Res 2002 91 : 727 732.
9. Shusterman V, Goldberg A, London B : Upsurge in T-wave alternans and nonalternating repolarization instability precedes spontaneous initiation of ventricular tachyarrhythmias in humans. Circulation 2006 113 : 2880 2887.
10. Stein PK, Sanghavi D, Domitrovich PP, Mackey RA, Deedwania P : Ambulatory ECG-based T-wave alternans predicts sudden cardiac death in high-risk post-MI patients with left ventricular dysfunction in the EPHESUS Study. J Cardiovasc Electrophysiol 2008 : DOI :.
11. Nearing BD, Verrier RL : Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy. J Appl Physiol 2002 92 : 541 549.
12. Kop WJ, Krantz DS, Nearing BD, Gottdiener JS, Quigley JF, O'Callahan M, DelNegro AA, Friehling TD, Karasik P, Suchday S, Levine J, Verrier RL : Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls. Circulation 2004 109 : 1864 1869.
13. Verrier RL, Nearing BD, La Rovere MT, Pinna GD, Mittleman MA, Bigger JT Jr., Schwartz PJ : Ambulatory electrocardiogram-based tracking of T wave alternans in postmyocardial infarction patients to assess risk of cardiac arrest or arrhythmic death. J Cardiovasc Electrophysiol 2003 14 : 705 711.
14. Nieminen T, Lehtimaki T, Viik J, Lehtinen R, Nikus K, Koobi T, Niemela K, Turjanmaa V, Kaiser W, Huhtala H, Verrier RL, Huikuri H, Kahonen M : T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. Eur Heart J 2007 28 : 2332 2337.
15. Lampert R, Shusterman V, Burg MM, Lee FA, Earley C, Goldberg A, McPherson CA, Batsford WP, Soufer R : Effects of psychologic stress on repolarization and relationship to autonomic and hemodynamic factors. J Cardiovasc Electrophysiol 2005 16 : 372 377.
16. Exner DV, Kavanagh KM, Slawnych MP, Mitchell LB, Ramadan D, Aggarwal SG, Noullett C, Van Schaik A, Mitchell RT, Shibata MA, Gulamhussein S, McMeekin J, Tymchak W, Schnell G, Gillis AM, Sheldon RS, Fick GH, Duff HJ : Noninvasive risk assessment early after a myocardial infarction: The REFINE study. J Am Coll Cardiol 2007 50 : 2275 2284.
17. Nieminen T, Lehtinen R, Viik J, Lehtimaki T, Niemela K, Nikus K, Niemi M, Kallio J, Koobi T, Turjanmaa V, Kahonen M : The Finnish Cardiovascular Study (FINCAVAS): Characterising patients with high risk of cardiovascular morbidity and mortality. BMC Cardiovasc Disord 2006 6 : 9.
18. Mason RE, Likar I : A new system of multiple-lead exercise electrocardiography. Am Heart J 1966 71 : 196 205.
19. Hostetler B, Xue J, Young B, Kaiser K, Findeis M, Gutterman D : Detect short run of TWA event with time-domain algorithm. Comput Cardiol 2005 32 : 483 486.
20. Kaiser W, Findeis M, Young B : Improving T-wave alternans measurement quality by reducing noise and artifacts. Comput Cardiol 2004 31 : 445 448.
21. Martinez JP, Olmos S, Wagner G, Laguna P : Characterization of repolarization alternans during ischemia: Time-course and spatial analysis. IEEE Trans Biomed Eng 2006 53 : 701 711.
22. Bloomfield DM, Hohnloser SH, Cohen RJ : Interpretation and classification of microvolt T wave alternans tests. J Cardiovasc Electrophysiol 2002 13 : 502 512.
23. Pajunen P, Koukkunen H, Ketonen M, Jerkkola T, Immonen-Raiha P, Karja-Koskenkari P, Mahonen M, Niemela M, Kuulasmaa K, Palomaki P, Mustonen J, Lehtonen A, Arstila M, Vuorenmaa T, Lehto S, Miettinen H, Torppa J, Tuomilehto J, Kesaniemi YA, Pyorala K, Salomaa V : The validity of the Finnish Hospital Discharge Register and Causes of Death Register data on coronary heart disease. Eur J Cardiovasc Prev Rehabil 2005 12 : 132 137.
24. Smith JM, Clancy EA, Valeri CR, Ruskin JN, Cohen RJ : Electrical alternans and cardiac electrical instability. Circulation 1988 77 : 110 121.
25. Tanno K, Ryu S, Watanabe N, Minoura Y, Kawamura M, Asano T, Kobayashi Y, Katagiri T : Microvolt T-wave alternans as a predictor of ventricular tachyarrhythmias: A prospective study using atrial pacing. Circulation 2004 109 : 1854 1858.
26. Raeder EA, Rosenbaum DS, Bhasin R, Cohen RJ : Alternating morphology of the QRST complex preceding sudden death. N Engl J Med 1992 326 : 271 272.
27. Hohnloser SH : Macroscopic T wave alternans as a harbinger of sudden death. J Cardiovasc Electrophysiol 1999 10 : 625.
28. Kodama M, Kato K, Hirono S, Okura Y, Hanawa H, Yoshida T, Hayashi M, Tachikawa H, Kashimura T, Watanabe K, Aizawa Y : Linkage between mechanical and electrical alternans in patients with chronic heart failure. J Cardiovasc Electrophysiol 2004 15 : 295 299.
29. Chow T, Kereiakes DJ, Onufer J, Woelfel A, Gursoy S, Peterson BJ, Brown ML, Pu W, Benditt DG : Primary results from the Microvolt T Wave Alternans Testing for Risk Stratification of Post MI Patients (MASTER I) trial (abstract). Circulation 2007 116 : 2631.
30. Ellenbogen KA, Levine JH, Berger RD, Daubert JP, Winters SL, Greenstein E, Shalaby A, Schaechter A, Subacius H, Kadish A, for the Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators : Are implantable cardioverter defibrillator shocks a surrogate for sudden cardiac death in patients with nonischemic cardiomyopathy? Circulation 2006 113 : 776 782.
31. Germano JJ, Reynolds M, Essebag V, Josephson ME : Frequency and causes of implantable cardioverter-defibrillator therapies: Is device therapy proarrhythmic? Am J Cardiol 2006 97 : 1255 1261.
32. Hohnloser SH, Ikeda T, Cohen RJ : Predictive accuracy of microvolt T-wave alternans testing in primary prevention patients with and without ICDs. Heart Rhythm 2008 (in press).
33. Verrier RL, Stone PH : Exercise stress testing for T wave alternans to expose latent electrical instability. J Cardiovasc Electrophysiol 1997 8 : 994 997.
34. Estes NA III., Michaud G, Zipes DP, El-Sherif N, Venditti FJ, Rosenbaum DS, Albrecht P, Wang PJ, Cohen RJ : Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. Am J Cardiol 1997 80 : 1314 1318.
35. Huikuri HV, Castellanos A, Myerburg RJ : Sudden death due to cardiac arrhythmias. N Engl J Med 2001 345 : 1473 1482.
36. Verrier RL, Kwaku KF, Nearing BD, Josephson ME : T-wave alternans: Does size matter? J Cardiovasc Electrophysiol 2005 16 : 625 628.
37. Klingenheben T, Gronefeld G, Li YG, Hohnloser SH : Effect of metoprolol and d,l-sotalol on microvolt-level T-wave alternans. Results of a prospective, double-blind, randomized study. J Am Coll Cardiol 2001 38 : 2013 2019.
38. Zacks ES, Morin DP, Ageno S, Janik M, Mauer AC, Markowitz SM, Mittal S, Iwai S, Shah BK, Lerman BB, Stein KM : Effect of oral beta-blocker therapy on microvolt T-wave alternans and electrophysiology testing in patients with ischemic cardiomyopathy. Am Heart J 2007 153 : 392 397.
39. Olsson G, Wikstrand J, Warnold I, Manger Cats V, McBoyle D, Herlitz J, Hjalmarson A, Sonneblick EH : Metoprolol-induced reduction in postinfarction mortality: Pooled results from five double-blind randomized trials. Eur Heart J 1992 13 : 28 32.