Risk stratification for sudden cardiac death: Is there a clinical role for T wave alternans?

被引：21

作者：

Cutler, Michael J. ^{[1
]}

Rosenbaum, David S. ^{[1
]}

机构：

[1] Case Western Reserve Univ, Heart & Vasc Res Ctr, Cleveland, OH 44109 USA

来源：

HEART RHYTHM | 2009年 / 6卷 / 08期

关键词：

Repolarization; Etectrophysiology; Tachycardia; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; POSTMYOCARDIAL INFARCTION PATIENTS; VENTRICULAR MUSCLE-FIBERS; ACTION-POTENTIAL DURATION; HEART-FAILURE; EJECTION FRACTION; VULNERABILITY; DYSFUNCTION; MORTALITY; PURKINJE;

D O I：

10.1016/j.hrthm.2009.05.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The proportion of cardiovascular deaths attributable to sudden cardiac death (SCD) is on the rise. Herein ties the rationale for developing risk stratification strategies to predict who will benefit from prophylactic implantable cardioverter-defibrillator (ICD) implantation. Current guidelines recommend prophylactic ICD therapy in patients with reduced left ventricular ejection fraction (LVEF). However, there are clear limitations in using LVEF alone to decide who should receive an ICD. There is mounting evidence that microvolt-level T-wave alternans (TWA) is an important marker of arrhythmic risk. TWA is appealing because it noninvasively probes the underlying electrophysiological substrate and has been linked to cellular mechanisms for arrhythmias. This review considers the clinical rote of TWA for risk stratification of SCD.

引用

页码：S56 / S61

页数：6

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