Reproducibility of microvolt T-wave alternans in patients with coronary artery disease
Therese Fuchs1, Marina Leitman, Itzhak Zysman
1Arrhythmia Service, Assaf Harofeh Medical Center, Zerifin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. therese@fuchs.org
Background:
Microvolt T-wave alternans (MTWA) measures subtle beat-to-beat fluctuations in the T-wave amplitude. It was found to be associated with cardiac electrical instability in patients with ischemic and dilated cardiomyopathy.
Objectives:
To investigate the reproducibility of the MTWA test results in patients with ischemic heart disease.
Methods:
The study group comprised patients with ischemic heart disease who participated in a rehabilitation program at the Assaf Harofeh Medical Center. MTWA was measured during a bicycle exercise test at the first encounter and repeated after one week.
Results:
Of the 40 study patients with coronary artery disease, 4 had an indeterminate result and were excluded from the data analysis; 5 had a positive MTWA in the first and second study (14%), 27 had a negative MTWA in the first and second study (75%), and 4 had a negative MTWA in the first study and a positive MTWA in the second study (11%). Overall, there was a correlation between the results of the first and the second study in 89% of the patients (kappa = 0.652, P = 0.0001).
Conclusions:
MTWA measurements are reproducible in the short term in patients with coronary artery disease.
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