American College of Cardiology - May 1, 2002, Volume 39, Number 9 (supplement B)

Many studies demonstred that T Wave Alternans (TWA) is a marker of life threatening ventricular arrhythmias among ischemic cardiomiopathy patients. Aim of study was to assess incidence of TWA and life threatening ventricular  arrhythmias in a population with ischemic cardiopathy and previous myocardial infarction.

METHOD:

We studied 34 patients (67% m; mean age 62+/- year) with previous myocardial infarction (1 – 12 months). We considered TWA to be present when V alt was> 1,9 microvolt during  bycicle exercise and K >3 in >1 orthogonal leads, or >1 adjacent precordial leads at heart rate 105/115 b/m. All patients undergone in same day at TWA, Holter 24 hours and Echocardiography.

RESULTS:

TWA was positive in 10/34 p. (29,4%) (Group TWA +) and negative in 24/34 (70,6%) (Group TWA - ) Holter monitoring shown ventricular arrhytmias, IV-V cl. Lown in 9/10 p.  (90%) of Group TWA + and in 8/24 (30%) of Group TWA-, (p < 0,001). Ejection fraction, by echocardiography, was 37% in Group TWA + and 41% in Group TWA -  (n.s.). During 15 months follow-up 2 p. of Group TWA+ has sustained ventricular tachicardia and ventricular  fibrillation and ICD paced versus none of Group TWA – (20% v. 0%)

CONCLUSIONS

Our  study demonstred  that TWA was positive in 29,4% of patients affected by ischemic cardiopathy and previous myocardial infarction. Incidence of life trheatening ventricular arrhythmias  was in Group TWA + higher than Group TWA – (90% v. 30%). TWA + can be considered a marker of life trheatening ventricular arrhythmias in a population with ischemic cardiopathy and previous myocardial  infarction.