Predictive power of T-wave alternans and of ventricular gradient hysteresis for the occurrence of ventricular arrhythmias in primary prevention cardioverter-defibrillator.

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Predictive power of T-wave alternans and of ventricular gradient hysteresis for the occurrence of ventricular arrhythmias in primary prevention cardioverter-defibrillator patients SumChe Man, MD, Priscilla V. De Winter, BSc, Arie C. Maan, PhD, Joep Thijssen, MD, C. Jan Willem Borleffs, MD, Wilbert P.M. van Meerwijk, PhD, Marianne Bootsma, MD, Lieselot van Erven, MD, Ernst E. van der Wall, MD, Martin J. Schalij, MD, Laura Burattini, PhD, Roberto Burattini, DrEng, Cees A. Swenne, PhD Journal of Electrocardiology Volume 44, Issue 4, Pages 453-459 (July 2011) DOI: 10.1016/j.jelectrocard.2011.05.004 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 1 Example of TWA analysis in a case-control patient pair. Upper panels: ECG lead V4 for the case patient (left); ECG lead V6 for the control patient (right). Lower panels: TWA signal for the case patient (left) and the control patient (right). In the case patient, TWAA was around 100 μV (twice the TWA signal amplitude), and control patient had less than 5 μV TWA. Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 2 Scatter plot of TWAA and SVGH values in case patients and in control patients. Spearman rank correlation analysis yielded no significant association, neither in cases (r = −0.16, P = .56) nor in control patients (r = −0.28, P = .27). Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 3 SVGH in 17 case-control patient pairs. For visual clarity, connecting lines were added and the case-control pairs were sorted on ascending values of the SVGH in the cases. Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 4 T-wave alternans amplitude in 17 case-control patient pairs. For visual clarity, connecting lines were added, and the case-control pairs were sorted on ascending values of the TWAA in the cases. Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 5 Receiver operating characteristics analyses for lethal arrhythmia prediction based on SVGH and on TWAA. Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 6 Kaplan-Meier analyses of the complete study group using the SVGH cutoff point of 14.8% and the TWAA cutoff point of 32.5 μV. Journal of Electrocardiology 2011 44, 453-459DOI: (10.1016/j.jelectrocard.2011.05.004) Copyright © 2011 Elsevier Inc. Terms and Conditions