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A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification

Michael R. Gold, MD, PhD, FACC^*, Daniel M. Bloomfield, MD, FACC, Kelley P. Anderson, MD, FACC, Nabil E. El-Sherif, MD, FACC, David J. Wilber, MD, FACC^||, William J. Groh, MD, FACC, N. A. Mark Estes, III, MD, FACC^#, Elizabeth S. Kaufman, MD, FACC, Mark L. Greenberg, MD, FACC^** and David S. Rosenbaum, MD, FACC^**

^* Department of Medicine, Division of Cardiology, University of Maryland Medical System, Baltimore, Maryland, USA
Columbia Presbyterian Medical Center, New York, New York, USA
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Veterans Affairs Medical Center, Brooklyn, New York, USA
^|| University of Chicago Hospitals, Chicago, Illinois, USA
^# New England Medical Center, Boston, Massachusetts, USA
^** MetroHealth Campus, Case Western Reserve University, Cleveland, Ohio, USA
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA

View larger version (20K): [in a new window]   Figure 1 Risk stratification of ventricular tachyarrhythmic events. Kaplan-Meier survival curves are shown for each of the three tests evaluated. A: T-wave alternans; B: Signal averaged electrocardiography; C: Programmed ventricular stimulation. EPS = programmed ventricular stimulation during electrophysiology study; SAECG = signal averaged electrocardiogram; TWA = T-wave alternans.

View larger version (20K): [in a new window]   Figure 2 The role of TWA for risk stratification in patients with known or suspected ventricular arrhythmias. Kaplan-Meier survival curves are shown based on TWA results. A: Ventricular tachyarrhythmic events is the end point. B: Ventricular tachyarrhythmic events or death is the end point. TWA = T-wave alternans.