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Incidence of T Wave Alternation After Acute Myocardial Infarction and Correlation with Other Prognostic Parameters: Results of a Prospective Study
Author(s) -
SCHWAB JÖRG OTTO,
WEBER STEFAN,
SCHMITT HEIKO,
STEENMUELLER MARYKAY,
COCH MICHAEL,
TILLMANNS HARALD,
BECKER MARC,
LENZEN CHRISTOPH,
WALDECKER BERND
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.00957.x
Subject(s) - medicine , t wave alternans , cardiology , myocardial infarction , prospective cohort study , incidence (geometry) , tachycardia , ventricular tachycardia , electrocardiography , sudden cardiac death , physics , optics
SCHWAB, J.O., et al. : Incidence of T Wave Alternation After Acute Myocardial Infarction and Correlation with Other Prognostic Parameters: Results of a Prospective Study. Tachycardia induced alternation of the T wave (TWA) has been associated with arrhythmia morbidity in mixed patient populations. However, less is known concerning the general incidence of TWA and its usefulness in risk stratification early after acute myocardial infarction (MI). TWA was prospectively and systematically assessed in 140 consecutive patients 15 ± 6 days after acute MI and prior to discharge. Results of TWA measurements were compared to other noninvasive risk markers, LV function, and coronary angiography. Sustained TWA was present at rest or inducible during exercise in 27% of patients. The patient‐specific heart rate for the onset of TWA was 98 ± 9 beats/min. After multivariate analysis, TWA correlated with age ( P = 0.02 ) and LV function ( P = 0.002 ) and occurred more often in patients after nonanterior MI ( P = 0.03 ). Acute results of Holter monitoring, late potentials by signal‐averaged ECG, and heart rate variability were unrelated to the TWA status. During follow‐up ( 451 ± 210 days) two major arrhythmic events occurred. The incidence of TWA early after MI is about 25%. TWA is related to age and LV function but not to other common arrhythmia markers. Although TWA does not appear to be related to excessive cardiac morbidity, evaluation of the prognostic significance of TWA requires further study.