PREVENT-SCA abstract

AHA 2009 TWA presentations

Risk stratification for sudden cardiac death: Is there a clinical

role for T wave alternans? (EXTRACT Heart Rhythm 2009;6:S56 –S61)

Circulation (July 21st) Correspondence

Letter by De Ferrari and Verrier Regarding Article, "Role of Microvolt T-Wave Alternans in Assessment of Arrhythmia Vulnerability Among Patients With Heart Failure and Systolic Dysfunction: Primary Results From the T-Wave Alternans Sudden Cardiac Death in Heart Failure Trial Substudy"

MTWA at the European Congress of Cardiology in Barcelona (August 31- Sept 1st)

Last issues:

The Efficacy of Microvolt T-Wave Alternans Testing and Other Noninvasive Risk Stratification Methods for Identifying Patients at Risk of Sudden Cardiac Death (EP Digest June 2009)

US registry points to substantial risk from ICD, pacemaker replacement

TWA Presentations at HRS 2009 in Boston

Can we alternate between T-wave alternans testing methods?

Heart Rhythm, Vol 6, No 3, March 2009

Heart Rhythm Journal: 4 NEW Full papers on MTWA

Special Issue  Supplement Issue: Risk Factors of Sudden Cardiac Death - Volume 6, Issue 3, Supplement (March 2009)

Evidence regarding clinical use of microvolt T-wave alternans,
Stefan H. Hohnloser, Takanori Ikeda, Richard J. Cohen (pdf)


Explaining the clinical manifestations of T wave alternans in patients at risk for sudden cardiac death, 13 October 2008
Michael J. Cutler, David S. Rosenbaum
pages S22-S28
Abstract | Full Text | Full-Text PDF (248 KB)

T-wave alternans in risk stratification of patients with nonischemic dilated cardiomyopathy: Can it help to better select candidates for ICD implantation?, 13 October 2008
Gaetano M. De Ferrari, Antonio Sanzo
pages S29-S35
Abstract | Full Text | Full-Text PDF (210 KB)

Strategies for reducing sudden cardiac death: Application of microvolt T-wave alternans testing in clinical practice, 07 January 2009
Michael J. Mirro
pages S45-S48
Abstract | Full Text | Full-Text PDF (71 KB)

Summary of Meta-analysis and other papers

NEW :Dr. Buxton (MUSTT Trial P.I.) comments to the 2008 AHA/ACC/HRS Scientific Statement on Noninvasive Risk Stratification (AHA Learning Library) - Summary




Yale University investigated whether anger-induced MTWA was associated with risk of arrhythmic events (Jacc March 2009)

February 2009:

Podcast posted on the Heart Rhythm Journal’s website:  Dr. Zipes, editor of the journal, interviews Dr. Rosenbaum about T wave alternanstopics include his take on the MASTER trial and how he uses MTWA in clinical practice:  

Click to Listen

From JACC: ABCD trial — T-wave alternans to improve sudden cardiac death prevention.

 Watch a related CVN video.

ABCD Trial Key Points

ABCD Trial published

Strategies Using T-Wave Alternans to Improve Efficiency of Sudden Cardiac Death Prevention Published (J Am Coll Cardiol 2009;53:471–9)

Editorial: Good results only if MTWA stress / pacing protocols and patient preparation are the standard ones


Impact of Age and Medical Comorbidity on the Effectiveness of Implantable Cardioverter-Defibrillators for Primary Prevention (Circulation January 6, 2009Full free on line): no significant differences in the degree of ICD mortality reduction benefit across age and medical comorbidity subgroups  but…

….find differences in the relative benefit associated with ICD therapy among patients screening high- and low-risk with MTWA (P=0.02)


SCD-Heft Substudy review paper published in Circulation Nov 11, Full  free on line

SCD-HeFT Substudy Review Summary

SCD-Heft Substudy and MASTER published…Comments from D. Rosenbaum , P.Chan and T. Chow

NEW : Potentially life-threatening VA (cycle length ≤260 ms) that resulted in appropriate ICD therapy are found to be more than 3 times the number of appropriate standard ICD Theraphy (J Cardiovasc Electrophysiol.  2008).

ICD therapy used again as end point in SCD-Heft Substudy? but if…Dr Epstein AE, Principal Author of ACC/AHA/HRS2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities wrote in JACC October 2008 : “The fact that ICD therapy is not a surrogate for resuscitation from cardiac arrest is not new information (NASPE 93)”

Biventricular pacing does not affect microvolt T-wave alternans in heart failure patients (Heart Rhythm 2008 ): it can be used before CRT implant.

The need of a better risk stratification: A critical appraisal of implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death. J Am Coll Cardiol. 2008

Evidence-based framework integrating TWA with other risk factors to stratify risk for sudden cardiac arrest (Progress in Cardiovascular Diseases, Vol. 51, No. 2 (September/October), 2008)

AHA/ACC/HRS Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death (Circulation. 2008;118:1497-1518.) : MTWA still the best method after EF

T-wave alternans test's prognostic horizon exceeds two years in analysis (August 1, 2008 issue of the American Journal of Cardiology.)

Review paper from Dr Theodore Chow( PI of Master Study)

Expert Commentary from T Chow paper







·        New Review Paper


·        AHA 2005 Studies Demonstrate Effectiveness of Microvolt T-Wave Alternans in Predicting Sudden Cardiac Death Regardless of Ejection Fraction on 2358 patients

·        European Congress of Cardiology August 2008 Munich TWA presentations

·      TWA presentations at AHA 2008

·         MTWA at CARDIOSTIM 2008 with related abstracts

·        Biventricular pacing attenuates T-wave alternans and T-wave amplitude compared to other pacing modes (Pacing Clin Electrophysiol. 2008 Jun)

·        New REVIEW paper

·         MTWA at ACC 2008 with abstracts

·        Video from the experience of a MTWA tested patient

·          European Heart Journal: T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test

·         Editorial on the European Heart Journal: T Wave Alternans: predicting the unpredictable



·        MASTER Study discussion on The

·         Dr Theodore Chow, Principal Investigator of MASTER I trial, statement

·         Latest news: ALPHA Study published on JACC on line

·         AHA 2007 Late-Breaking Clinical Trials:

·         MASTER I Study results

·         Comments from

·         Reference paper to understand the results: Frequency and causes of implantable cardioverter-defibrillator therapies: is device therapy proarrhythmic? (Am J. Card)

·         Editorial: New MTWA studies on ICD patients, end points, follow up time, indeterminate results and MTWA Stress /EP protocols.


·         NEW on Int J. Card: Combined prognostic value of peak O2 uptake and microvolt level T-wave alternans in patients with idiopathic dilated cardiomyopathy


·         New paper on PACE : MTWA on Diabetic Patients:

·         Relationship between abnormal Microvolt T Wave Alternans and poor glycemic control in type 2 diabetic patients


·         New paper on JACC:

·         Predictive Value of Microvolt T-Wave Alternans in Patients With Left Ventricular Dysfunction


·         Editorial: New MTWA studies on ICD patients, end points, follow up time, indeterminate results and MTWA Stress /EP protocols.


·         Other issues:


·         The first European Multicenter Clinical Trial: The ALPHA (T-Wave Alternans in Patients With Heart Failure) clinical study late-breaker presentation during plenary session (

·         The ALPHA Study and review of the latest MTWA studies at Cardiosource (ACC)

·         Other MTWA presentations at ACC


·         2  papers on JACC:

·         Microvolt T-Wave Alternans Identifies Patients With Ischemic Cardiomyopathy Who Benefit From Implantable Cardioverter-Defibrillator Therapy ( J Am Coll Cardiol, 2007;49:50-58):

·         -Abstract at JACC

·         -Expert moderated discussion at JACC NEW

·         -Full paper at Medscape

·         -Comments at

·         Predictive Value of Microvolt T-Wave Alternans for Sudden Cardiac Death in Patients With Preserved Cardiac Function After Acute Myocardial Infarction (JACC 2006;48:2268-74)

·         Comments at

·         ACC/AHA/ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Cardiac Death – Extracted Sections on  T Wave Alternans in Class 2a (Level of Evidence A): All reference papers are based on the Spectral Analytic Method


·         Microvolt T-Wave Alternans (TWA) Testing: Can It Identify Athletes at High Risk of Ventricular Arrhythmias and Sudden Cardiac Death?

·         Cost-Effectiveness of a Microvolt T-Wave Alternans Screening Strategy for Implantable Cardioverter-Defibrillator Placement in the MADIT-II–Eligible Population (JACC June 7on line )


·         MEDICARE  Decision Memo for Microvolt T-wave Alternans (ONLY Spectral Method) for patients who may need an ICD

·         Comments to the MEDICARE Decision Memo:

·         - Editor Comment

·         -The Wall Street Journal


·         European Congress of Cardiology Vienna September 2007 ABSTRACTS

·          AHA MTWA Abstracts 2007

·        mshbul1a Heart Rhythm Society 2007 in Denver :

·         20 MTWA presentations

·         MTWA Session: T Wave Alternans. Mechanism and Implications to Clinical Practice

·         Best Clinical MTWA abstracts 

·        mshbul1a        Italian Congress of Cardiology (ANMCO) June 5

·        mshbul1a        ISHNE Congress Athens Greece June 7-9

·         mshbul1a        MTWA presentations at EUROPACE – June 2007 in Lisbon

·         mshbul1a        New paper on JACC: Prognostic Utility of Microvolt T-Wave Alternans in Risk Stratification of Patients With Ischemic Cardiomyopathy

·         mshbul1a Endocardial and Epicardial Repolarization Alternans in Human Cardiomyopathy - Evidence for Spatiotemporal Heterogeneity and Correlation With Body Surface T-Wave Alternans (J Am Coll Cardiol, 2007; 49:338-346)

·         mshbul1a Medicare proposes drastic reductions in reimbursement for cardiovascular procedures ICD implantation would be reduced by about a quarter… so MTWA could be necessary

·         mshbul1a Medscape: Microvolt T-Wave Alternans Testing and ICD Risk Stratification: An Expert Interview With Anne B. Curtis, MD President of the Heart Rhythm Society

·         mshbul1a MTWA at ACC: Meet the experts Sessions ”T-Wave Alternans Negative Patients Do Not Need an Implantable Cardioverter Defibrillator” and the best MTWA abstracts

·         mshbul1a Best T Wave Alternans AHA 2006 abstracts

·         mshbul1aThe Cost Effectiveness of Implantable Cardioverter-Defibrillators: Results From the Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II (JACC 2006;47:2310-2318)


·         mshbul1aMicrovolt T-Wave Alternans with Exercise in Pediatrics and Congenital Heart Disease: Limitations and Predictive Value

·        mshbul1aMTWA Session at Heart Rhythm 2006 Scientific Sessions (HRS) with abstracts

·         mshbul1aAdditional MTWA sessions and abstracts at HRS

·        mshbul1aCARDIOSTIM 2006( Nice, June 14 - 17 ) MTWA updated presentations with abstracts

·         mshbul1aNew paper: MTWA test can be performed on Atrial Fibrillation patients with simultaneous A-V pacing: Editor Comment


·         mshbul1aAm J Cardiol 2006: Frequency and causes of implantable cardioverter-defibrillator therapies: is device therapy proarrhythmic?


·         mshbul1a The Wall Street Journal (Nov. 1st ,2005):T Wave Test for Patients Facing Defibrillator Recall


·         mshbul1a MTWA Session at AHA 2005 with abstracts


·         mshbul1a Predictive significance for sudden death of microvolt-level T wave alternans in New York Heart Association class II congestive heart failure patients ,A prospective study (International Journal of Cardiology, Volume 105, Issue 1 , 20 October 2005)


·         mshbul1a  ACC 2005 in Orlando: 7 new presentations

·         mshbul1a T-wave alternans could surpass LVEF as risk-stratifier for ICD Implantation

·         mshbul1a Heart Rhythm 2005 Congress in New Orleans: 20 Presentations and best abstracts

·         mshbul1a Clinical Utility of T-Wave Alternans (ACCEL ONLINE)

·         mshbul1a The Lancet: T Wave Alternans Stratifies Defibrillator Candidates in MADIT II type patients (Lancet 2003;362:91-92) Answers to Commentary

·        mshbul1a JACC : SCD most likely to strike when LVEF doesn't meet criteria for prophylactic ICD

·        mshbul1a Measurement of microvolt T-wave alternans, a new arrhythmic risk stratification test, in Type 2 diabetic patients without clinical cardiovascular disease (Diabetic Medicine Volume 23 Page 207  - February 2006)

·         mshbul1a MTWA in MADIT II type patients - Review paper

·         mshbul1a paper on Circulation: Microvolt T-Wave Alternans as a Predictor of Ventricular Tachyarrhythmias: A Prospective Study Using Atrial Pacing Circulation 2004;109 1854-1858

·         mshbul1a NASPE 2004: Identification of response to Resynchronization Therapy

·        mshbul1a  MTWA as Predictor of Electrophysiology Testing Results in Professional Competitive Athletes with 23 months follow up  A.N.E  2004;9(3):1-6

·         mshbul1a  NEW 6 presentations at AHA 2004 in New Orleans

·         mshbul1a Spontaneous Ventricular Tachycardia and Fibrillation in a Patient with Positive MicroVolt T Wave Alternans Test and Negative Electrophysiological Study  (PACE 2004; 27:1-3)

·         mshbul1a The ALPHA study ( T wave Alternans in Patients with Heart fAilure): rationale, design and endpoints (Ital Heart J 2004; 5(8):587-592)

·         mshbul1a ACC 2004 : 14 New presentations with  8 Clinical abstracts

·        mshbul1a T Wave Alternans is a Predictor of Death in Patients with Congestive Heart Failure ( International Journal of Cardiology 2004; Vol 93 )

·         mshbul1a Use of BetaBlockers during MTWA Test in DCM patients: Editor Comment   

·        mshbul1a CARDIOSTIM 2004  MTWA    presentations with best abstracts

·         mshbul1a MTWA at NASPE 2003:- 5 new posters and one presentation

·         mshbul1a Low value of EP testing in MADIT II population

·         mshbul1a ESC 2003: The comparison of principal component analysis (PCA) ratio with QT dispersion (QTd) and T-wave alternans in patients with old myocardial infarction.

·        mshbul1a ACC2003 MADITII patients:-Late Breaking Clinical Trials,-“T-Wave Alternans in Congestive Heart Failure,” Daniel Bloomfield, MD, Columbia Presbyterian, New York City

·         mshbul1a Repolarization Alternans: Implications for the mechanism and prevention of sudden death, David Rosembaum Cardiovascular Research Vol 57(3) (2003)(pdf file on request)

·         mshbul1a Usefulness of MTWA for Prediction of VT Events in Patients with Dilated Cardiomyopathy: Results From a Prospespective Study (JACC Vol 41, No 12, 2003) pdf files on request

·         mshbul1a Intravenous Administration of Class I Antiarrhythmic Drug Induced T Wave Alternans in an Asymptomatic Brugada Syndrome Patient (PACE 2003 ;26:1900-1903)

·         mshbul1a AHA 2003  11  presentations abstracts  Microvolt T-Wave Alternans Identifies MADIT II Type Patients at Low Risk of Ventricular         Tachyarrhythmic Events (poster abstract)      

·         mshbul1a Effects of Selective Autonomic Blockade on T-Wave Alternans in Humans ( Circulation. 2002;105 105:837)

·         mshbul1a Abstracts at ACC 2002

·         mshbul1a“Clinical Use of Microvolt T-Wave Alternans Testing in the Electrophysiology Laboratory”

·         mshbul1aNASPE 2002 abstracts

·         mshbul1a M T Wave Alternans as predictor of malignant tachyarrhythmias in athletes (abstract) published on GIAC, Vol 5, March 2002(*)

·         mshbul1a MTWA at CARDIOSTIM 2002

·         mshbul1a  MTWA at European Congress of Cardiology

·         mshbul1a  MTWA and Tetralogy of Fallot    J C E July 2002 (first page pdf file)

·         mshbul1a  MTWA Short-Term Reproducibility  JCE July 2002 (first page pdf file)

·         mshbul1a        Pathophysiological Basis JACC Vol 40 No2, 2002 (first page pdf file)

·         mshbul1a MADIT II Type Patients Successfully Risk Stratified By MTWA

·         mshbul1a Alternans of Action Potentials During Atrial Flutter as a Precursor to Atrial Fibrillation (Circulation 2002;106:1968) abstract

·         mshbul1a AHA 2002 Scientific Session: 9 MTWA presentations with ABSTRACTS

·        mshbul1a MTWA is associated with left ventricle remodeling after myocardial infarction

·         mshbul1a His Electrogram Alternans Reveal Dual Atrioventricular Nodal Pathway Conduction During Atrial Fibrillation: The Role of Slow-Pathway Modification

·         mshbul1a  ICD meta-analysis: Risk stratification remains the challenge

·        mshbul1a Does Biventricular Pacing Decrease the Incidence of Microvolt T-Wave Alternans? (Abstract)

·         mshbul1a  JACC full text: Comparison of  TWA, Signal averaged ECG and programmed Stimulation for Arrhythmia risk Stratification  (pdf); December 2000  (*)

·         mshbul1a Full text TWA Review paper   (**)

·         mshbul1a Micro TWA Study Matrix

·        mshbul1a ABSTRACTS AC ACC 2001

·         mshbul1a Hypertension: T Wave Alternans and V. Arrhythmias in Arterial Hypertension;  February 2001 ABSTRACT,FULL TEXT  (pdf)(*)

·        mshbul1a NASPE 2001 TWA Abstracts

·         mshbul1a TWA at Europace and  ESC 2001 abstracts

·         mshbul1a TWA in the Task Force Report on Sudden Death of ESC

·        mshbul1a Clinical Usefullness of the Combination of TWA and late Potentials for Identifying High Risk Patients with Moderately or Severely Impared Left Ventricular Function ( first page pdf file)  (*)

·         mshbul1a Predicting the Recurrence of Ventricular Tachyarrhythmias from TWA on Antiarrhythmic Pharmacotherapy (first page pdf file) (*)

·        mshbul1a Optimal Target Heart Rate for Exercise-Induced T Wave Alternans, Nabil El-Sherif ANE  2001 First Page pdf file (*)

·         mshbul1a ABSTRACTS at AHA 2001         

·         mshbul1a MADIT II: Facts and MTWA Statements

·         mshbul1a New 2002 published papers (review):T Wave Alternans as Predictor for Sudden Death After Myocardial Infarction ( AJC Vol. 89 Jan 1, 2002) (*)Onset Heart Rate of Microvolt TWA Provides Clinical and Prognostic Value in Nonischemic Dilated Cardiomyopathy (JACC Vol. 3, No 2, 2002)(*)Effect of Metropol and d,l-Sotalol on MicroVolt TWA (Vol. 38, No 7, 2001(*): (*)Pdf files on request

·         mshbul1a Full Text T Wave Alternans overview paper ( published on MASPE Journal) (**)

·         mshbul1a ABSTRACTS AT ACC 2000

·         mshbul1a ABSTRACTS AT NASPE 2000

·         mshbul1a Abstract and Editor C. of Buxton A. NEJM 2000 “ EPS to Identify Pts with CAD at Risk for Sudden Death”

·         mshbul1a The Lancet  full text: Predictive value of TWA for arrhythmic events in patients with Congestive Heart Failure (pdf ); August 2000 (*) 

·         mshbul1a Updated: Medicare Increases Payment for Microvolt T-Wave Alternans Test by 50%

·         mshbul1a ABSTRACTS AT ACC 99

·         mshbul1a PAPERS Published on Circulation

·         mshbul1a ABSTRACTS AT NASPE 99

·         mshbul1a ABSTRACTS AT AHA 99

·         mshbul1a Syncope Patients Dan Bloomfield full Abstract AHA 99