Risk stratification for sudden cardiac death: Is there a clinical role for T wave alternans?
Risk stratification for sudden cardiac death: Is there a clinical role for T wave alternans?
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DOI：
10.1016/j.hrthm.2009.05.025
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发表时间：
2009-08-01
期刊：
影响因子：
5.5
通讯作者：
Rosenbaum, David S.
中科院分区：
文献类型：
--
作者：
Cutler, Michael J.;Rosenbaum, David S.
心源性猝死（SCD）导致的心血管死亡比例正在上升。本文结合了制定风险分层策略的基本原理，以预测谁将从预防性植入式心律转复除颤器（ICD）植入中受益。目前的指南建议对左心室射血分数（LVEF）降低的患者进行预防性ICD治疗。然而，单独使用LVEF来决定谁应该接受ICD有明显的局限性。越来越多的证据表明，微伏级T波电交替（TWA）是一个重要的标志物的风险。TWA是吸引人的，因为它非侵入性地探测潜在的电生理底物，并已被链接到心律失常的细胞机制。该综述考虑了TWA用于SCD风险分层的临床规则。
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.