Microvolt T-wave alternans testing should be used to guide arrhythmic therapy in heart failure patients
Name
20120515_Letter to European Journal of Heart Failure.pdf
Size
65.97 KB
Format
Adobe PDF
Checksum (MD5)
4d5f29138c49fefcf9f4bdb9d3aae8af
Author(s)
Cohen, Richard J.
Hohnloser, Stefan H.
Date Issued
May 2012
Journal
European Journal of Heart Failure
Publisher
Oxford University Press
Citation
Hohnloser, S. H., and R. J. Cohen. “Microvolt T-wave alternans testing should be used to guide arrhythmic therapy in heart failure patients.” European Journal of Heart Failure 14, no. 6 (May 24, 2012): 677-678.
Version
Author's final manuscript
Abstract
Jackson et al. reported on a cohort of heart failure patients and concluded that microvolt T-wave alternans (MTWA) testing has limited utility in this population. Of note, this assessment was made in the complete absence of any outcomes data. The authors base their assessment on the fact that they deemed 318 of 648 patients to be ineligible for MTWA testing. The ineligibility was primarily attributable to the 38% incidence of atrial fibrillation which they reported while noting that this incidence was substantially higher than the 23% incidence reported in two earlier studies. Seventy-six patients were deemed ineligible for MTWA testing due to inability to exercise or continuous ventricular pacing. The authors ignored the availability of pharmacological and pacing protocols to test this latter group of patients. Moreover, patients who cannot exercise on a treadmill often are able to elevate their heart rate adequately for MTWA testing (≥105 b.p.m.) by means of isometric exercise or stepping in place.
MIT Department
Harvard University--MIT Division of Health Sciences and Technology
Terms of Use
Creative Commons Attribution-Noncommercial-Share Alike 3.0
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1093/eurjhf/hfs075
