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Figure 1 Simplified schematic of Markov model. The square node at the far left symbolizes the choice between the three treatment strategies: implantable cardioverter-defibrillators (ICDs) for all, medical therapy, or risk stratification with microvolt T-wave alternans (MTWA) testing. Circles represent chance events, and M represents the Markov process with multiple health states (well, mildly disabled, moderately disabled, severely disabled) for each treatment option. Patients who survive ICD implantation or who are on medical therapy enter the Markov tree (denoted by two circles and arrow within a rectangle), which includes all potential clinical outcomes that occur with each cycle. Patients in the medical therapy arm are not subject to ICD complications and have no cardiac arrests prevented by defibrillator therapy. Patients in the MTWA risk stratification strategy enter the same pathway as those in the ICD-for-all strategy if they test MTWA non-negative and the medical therapy strategy if they test MTWA negative.
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