T-wave alternans for risk stratification and prevention of sudden cardiac death.

Détails

ID Serval
serval:BIB_921969C8E1C2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
T-wave alternans for risk stratification and prevention of sudden cardiac death.
Périodique
Current Cardiology Reports
Auteur(s)
Pruvot E.J., Rosenbaum D.S.
ISSN
1523-3782
Statut éditorial
Publié
Date de publication
09/2003
Volume
5
Numéro
5
Pages
350-357
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Review
Résumé
Despite considerable progress in the management of ischemic heart disease, a substantial proportion of patients continue to experience life-threatening arrhythmic events. The Multicenter Automatic Defibrillator Implantation Trial 2 has recently shown the superiority of implantable cardioverter defibrillators (ICDs) over conventional strategies to prevent sudden death in patients with reduced ejection fraction, but at the expense of potentially unnecessary ICD implantation in a large percentage of patients. T-wave alternans (TWA), which reflects alternation of cellular repolarization, results in a substantial increase in dispersion of repolarization, a prerequisite for reentrant arrhythmias. Recent trials, cumulating close to 3000 patients, have established TWA analysis as a powerful tool for arrhythmia prevention. Based on the most recent estimates, at least one third of post-myocardial infarction patients are expected to be tested negative. With a negative predictive value greater than 90%, TWA might allow for targeting of patients most likely to benefit from ICD therapy. Accurate identification of high-risk patients by noninvasive TWA may allow for improved widespread screening for sudden death prevention in the general population.
Mots-clé
Arrhythmias, Cardiac/epidemiology, Arrhythmias, Cardiac/physiopathology, Death, Sudden, Cardiac/epidemiology, Death, Sudden, Cardiac/etiology, Defibrillators, Implantable, Disease Progression, Electrocardiography, Heart Rate/physiology, Humans, Incidence, Risk Factors, United States/epidemiology
Pubmed
Création de la notice
28/01/2008 11:04
Dernière modification de la notice
20/08/2019 15:55
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