Introduction. Aim of our study is to evaluate the role of TWA to stratify the risk of
sudden cardiac death in athletes (Ath) with complex ventricular arrhythmias (VA), and to document
a possible correlation between TWA and electrophysiological testing (EES) results.
Methods. We studied 43 Ath with VA (31 M, mean age 34 ± 12 years). In all cases a cardiological evaluation was performed, including TWA and EES. The patients were evaluated during a followup of 25 ± 22 months. The end-point was the occurrence of sudden death or malignant ventricular tachyarrhythmias (VT).
Results. TWA was negative in 28 Ath (65%), positive in 8 (19%) and indeterminate in 7 (16%). All subjects with negative TWA did not show induction of VT at EES, with significant correlation between negative TWA and negative EES (p<0.001). All Ath with positive TWA also had VT induced by a EES, but without significant correlation between positive TWA and positive EES. In 2 Ath with undetermined TWA (29%) VT were induced at EES. Our data did not show significant correlation between indeterminate TWA and positive or negative EES. However, logistic regression analysis showed significant correlation between abnormal TWA test (positive or indeterminate) and inducibility of VT at EES (p<0.001). During follow-up we observed a significant difference in end-point occurrence between Ath with negative or positive TWA and between Ath with negative or positive EES.
Conclusion. TWA confirm its role as a simple and non-invasive test, and it seems useful for prognostic stratification of Ath with VA. (Heart International 2007; 3: 58-67)
T-wave alternans, Sudden death, Ventricular arrhythmias, Sport activity
Giuseppe Inama, MD, Department of Cardiology, Ospedale Maggiore, L.go U. Dossena, 2, 26013 Crema – Italy, firstname.lastname@example.org
Share this Article
Related Content In Arrhythmia
Spontaneously Recanalized Coronary Thrombus in the Left Anterior Descending Artery Presenting as Ventricular Tachycardia
Heart International. 2020;14(2):123-8 DOI: https://doi.org/10.17925/HI.2020.14.2.123
Spontaneously recanalized coronary thrombus (SRCT), informally known as Swiss-cheese, honeycomb, lotus root or spiderweb lesion, is an increasingly recognised pathology in patients undergoing coronary angiography. Most patients with SRCT present with angina or angina equivalent.1 We describe a case of SRCT in a patient who presented with ventricular tachycardia (VT) without a previous history of ischaemic […]
Prolonged Extracorporeal Membrane Oxygenation Support In a Patient with Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome-associated Fulminant Myocarditis – A Case Report and Literature Review
Heart International. 2020;14(2):112-7 DOI: https://doi.org/10.17925/HI.2020.14.2.112
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous adverse drug reaction. Symptoms comprise fever, lymphadenopathy, rash, and eosinophilia, with or without visceral organ involvement. The extent of internal organ involvement, including hepatitis, myocarditis, pneumonitis, thyroiditis, and pancreatitis, determines the morbidity and mortality associated with the disease.1–3 We report a case of […]
Atrial Fibrillation and Dementia
European Journal of Arrhythmia & Electrophysiology. 2020;6(1):10-6 DOI: https://doi.org/10.17925/EJAE.2020.6.1.10
Atrial fibrillation (AF) is one of the most common arrhythmias. It affected 33.5 million people worldwide in 2010, a number that is expected to double by 2050.1 AF prevalence increases with age, and approximately 25% of individuals aged 40 years or older will develop AF during their lifetime.2,3 Irrespective of age, AF incidence also increases with diabetes […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!