Predictive value of T-wave alternans for arrhythmic events in patients with congestive heart failure

Lancet. 2000 Aug 19;356(9230):651-2. doi: 10.1016/s0140-6736(00)02609-x.


Measurement of microvolt level T-wave alternans in the surface electrocardiogram is a novel way to assess the risk of ventricular arrhythmias. Seven tests of arrhythmic risk, including T-wave alternans, were undertaken in 107 consecutive patients with congestive heart failure and no history of sustained ventricular arrhythmias; the patients were followed up for arrhythmic events during the next 18 months. Of the patients with events, 11 had positive and two indeterminate T-wave alternans results; there were no arrhythmic events among patients with negative T-wave alternans results. Of the seven tests, only T-wave alternans was a significant (p=0.0036) and independent predictor of arrhythmic events.

Publication types

  • Clinical Trial
  • Letter

MeSH terms

  • Arrhythmias, Cardiac / diagnosis*
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Electrocardiography*
  • Female
  • Follow-Up Studies
  • Heart Failure / complications*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Assessment
  • Survival Rate