Related Experiment Video
Updated: Aug 7, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Value of microvolt T-wave alternans for predicting patients who would benefit from implantable
Majid Haghjoo1, Arash Arya, Mohammad Ali Sadr-Ameli
1Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. majid.haghjoo@gmail.com
Insights
Microvolt T-wave alternans (MTWA) shows promise in identifying patients who will benefit from implantable cardioverter-defibrillator (ICD) therapy. This noninvasive method may reduce unnecessary ICD implantations and improve sudden cardiac death prevention strategies.
Area of Science:
- Cardiology
- Electrophysiology
- Biomedical Engineering
Background:
- Coronary artery disease and dilated cardiomyopathy management still leave patients at risk of fatal arrhythmias.
- Prophylactic implantable cardioverter-defibrillator (ICD) therapy reduces mortality but leads to many unnecessary implantations.
Purpose of the Study:
- To evaluate the utility of Microvolt T-wave alternans (MTWA) in selecting patients for ICD therapy.
- To assess MTWA's potential for improving the efficiency of sudden cardiac death prevention.
Main Methods:
- Utilizing Microvolt T-wave alternans (MTWA) as a noninvasive diagnostic tool.
- Analyzing data from large-scale clinical studies like the Multicenter Automatic Defibrillator Implantation II and Sudden Cardiac Death Heart Failure trials.
Main Results:
- MTWA demonstrates a negative predictive value exceeding 90% for identifying patients unlikely to benefit from ICDs.
- Accurate risk stratification using MTWA can potentially decrease unnecessary ICD procedures.
Conclusions:
- Noninvasive MTWA testing is a promising tool for patient selection for prophylactic ICD implantation.
- Widespread screening with MTWA could enhance the effectiveness of sudden cardiac death prevention efforts.
Abstract:
Despite considerable progress in the management of coronary artery disease and dilated cardiomyopathy, a substantial proportion of patients remains at the risk of life-threatening arrhythmic events. The Multicenter Automatic Defibrillator Implantation II and Sudden Cardiac Death Heart Failure studies have conclusively demonstrated that prophylactic implantable cardioverter-defibrillator (ICD) therapy reduces mortality among subjects with ischemic and nonischemic cardiomyopathy but at the expense of potentially unnecessary ICD implantation in a large percentage of patients. Microvolt T-wave alternans (MTWA), with a negative predictive value greater than 90%, holds promise for selecting the patients who would likely and patients not likely to benefit from ICD implantation. Accurate identification of high-risk patients by noninvasive MTWA may allow for improved widespread screening for sudden death prevention in the general population.
Related Concept Videos
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:25Dysrhythmias VI: Management of Dysrhythmias
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...