©© www.alternans.org
MicroVolt T
Wave Alternans (MTWA) Risk
Assessment of
Malignant Arrhythmias (introduction)
In Class IIa (level of Evidence A)
in AHA/ACC/ESC Guidelines
European News
Web Page
Editor: D. Marangoni Updated May 16, 2012
..............
Soccer star's cardiac
arrest prompts screening questions
Reminder:
MTWA risk assessment in Professional
Athletes papers:
Heart Rhythm. 2012 Feb 25. [Epub ahead of
print]
ACC
2012 New Meta Analysis :MTWA predictive also in ICD patients
NEW: MTWA Reimbursement
in Japan
Role
of Substrate and Triggers in the Genesis of Cardiac Alternans,
From the Myocyte
to the Whole Heart: Implications for Therapy Faisal
M. Merchant and Antonis A. Armoundas ( Circulation 2012;125 539-549)
Good opportunity to use mTWA in Decision
Making with the Informed
Consent:
·
Don't routinely replace spent ICDs:
Proposal (January, 2012 New England Journal of Medicine)
Very Important
presentations at Venice Arrhythmias 2011:
·
Real
world money saving with MTWA application (abstract)
·
No
correlation between mtwa Spectral method and MMA
TWA(abstract).
T-wave Alternans Testing in Pacemaker Patients Comparison of Pacing Modes and Long-Term
Prognostic Relevance (5 years follow up) - Pacing and Clinical Electrophysiology
-
The
Use of MTWA in the Detection of Ischemia
MTWA
Warns of Impending Cardiac Arrest (Diagnostic and Interventional
Cardiology - Oct 11)
Implementation
of ICD guidelines is difficult in European countries facing budget crunch
80% of
SCD in Women Could Be Avoided With All-Around Healthy Lifestyle - JAMA 2011; 306:62-69
( ICDs are not always necessary but risk
analysis is necessary)
Relationship
Between Early Diastolic Dysfunction and Abnormal Microvolt
T-Wave
Alternans in Patients with Type 2 Diabetes
(Circulation I. March 2011)
Toward
More Optimal Use of Primary Prevention
Implantable
Cardioverter-Defibrillators (extracted from
Circulation C. March 2011)
Irritable
Contemporary Risk of Implantable Cardioverter
Defibrillators (
select better your patients)
TWA
inside ICD (Circulation February 28, 2011)
Mechanisms
Underlying the Lack of Effect of Implantable Cardioverter-Defibrillator
Therapy on Mortality in High-Risk Patients With Recent Myocardial Infarction
Insights
from the Defibrillation in Acute Myocardial Infarction Trial (DINAMIT)
.. Select better your patients
..
Primary ICD implants may not
benefit seniors
...Thats why a better
stratification method is needed...
Ongoing
Clinical Trials on MTWA
MTWA at 2010
European Congress of Cardiology
ESC important abstract on
Pacing modes
Shocking
revelations at the HRS
(thats
why it is better to select the ICD patients)
MTWA HRS 2010
Denver presentations
(Circ Arrhythm Electrophysiol. 2009;2:686-694.)
|
Risk
stratification for sudden cardiac death: Is there a clinical role
for T wave alternans? (EXTRACT
Heart Rhythm 2009;6:S56 S61) Circulation (July 21st) Correspondence
|
Letter by
De Ferrari and Verrier Regarding Article, "Role
of Microvolt T-Wave Alternans in Assessment of
Arrhythmia Vulnerability Among Patients With Heart Failure and Systolic Dysfunction:
Primary Results From the T-Wave Alternans Sudden
Cardiac Death in Heart Failure Trial Substudy"
MTWA at the
European Congress of Cardiology in Barcelona (August 31- Sept 1st)
Last issues:
US registry
points to substantial risk from ICD, pacemaker replacement
TWA
Presentations at HRS 2009 in Boston
Can we alternate between T-wave alternans testing methods?
Heart
Rhythm, Vol 6, No 3, March 2009
Yale
University investigated whether anger-induced MTWA was associated with risk of
arrhythmic events (Jacc March 2009)
February 2009:
Podcast posted on the Heart Rhythm Journals website: Dr. Zipes, editor of the journal, interviews Dr. Rosenbaum
about T wave alternans topics include his take on the
MASTER trial and how he uses MTWA in clinical practice:
Click to Listen http://www.heartrhythmjournal.com/webfiles/images/journals/hrthm/Feb09_David_Rosenbaum_Interview.mp3
From JACC: ABCD
trial T-wave alternans to improve sudden cardiac
death prevention.
Watch a related CVN
video. 
2008
SCD-Heft Substudy review paper published in Circulation Nov 11,
Full free on line
SCD-HeFT
Substudy Review Summary
SCD-Heft Substudy and MASTER
published
Comments from D. Rosenbaum , P.Chan and T.
Chow
NEW : Potentially life-threatening VA (cycle length ≤260
ms) that resulted in appropriate ICD therapy are found to be more than 3 times
the number of appropriate standard ICD Theraphy (J Cardiovasc
Electrophysiol. 2008).
ICD therapy used again
as end point in SCD-Heft Substudy? but if
Dr Epstein
AE, Principal Author of ACC/AHA/HRS2008 Guidelines for Device-Based Therapy
of Cardiac Rhythm Abnormalities wrote in JACC October 2008 : The fact that
ICD therapy is not a surrogate for resuscitation from cardiac arrest is not new
information (NASPE 93)
Biventricular
pacing does not affect microvolt T-wave alternans in heart
failure patients (Heart Rhythm 2008 ): it can be used before CRT implant.
AHA/ACC/HRS
Scientific Statement on Noninvasive Risk
Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac
Death (Circulation. 2008;118:1497-1518.) : MTWA still the best
method after EF
Review
paper from Dr Theodore Chow( PI of Master Study)
Expert Commentary from
T Chow paper
|
|
For
additional information: |
|
|
ACC/AHA/ESC
Guidelines for the Management of Patients with Ventricular Arrhythmias and
the Prevention of Cardiac Death Extracted Sections on T Wave Alternans
in Class 2a (Level of Evidence A): All reference papers are based on the
Spectral Analytic Method |
|
Additional Info on T Wave Alternans
products : http://www.cambridgeheart.com
|