Journal of Electrocardiology
Volume 43, Issue 3 , Pages 251-259 , May 2010

Association of Holter-based measures including T-wave alternans with risk of sudden cardiac death in the community-dwelling elderly: the Cardiovascular Health Study

  • Phyllis K. Stein, PhD

      Affiliations

    • Washington University School of Medicine, St. Louis, MO, USA
    • Corresponding Author InformationCorresponding author. Washington University School of Medicine HRV Laboratory, 4625 Lindell Blvd, Suite 402, St. Louis, MO 63108, USA.
  • ,
  • Devang Sanghavi, MD

      Affiliations

    • Washington University School of Medicine, St. Louis, MO, USA
  • ,
  • Nona Sotoodehnia, MD

      Affiliations

    • University of Washington, Seattle, WA, USA
  • ,
  • David S. Siscovick, MD, MPh

      Affiliations

    • University of Washington, Seattle, WA, USA
  • ,
  • John Gottdiener, MD

      Affiliations

    • University of Maryland School of Medicine, Baltimore, MD, USA

Received 30 October 2009

References 

  1. Myerberg R. Sudden cardiac death: exploring the limits or our knowledge. J Cardiovasc Electrophysiol. 2001;12:369
  2. Abdalla IS, Prineas RJ, Neaton JD, Jacobs DR, Crow RS. Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men. Am J Cardiol. 1987;60:1036
  3. Moss AJ, Davis HT, DeCamilla J, Bayer LW. Ventricular ectopic beats and their relation to sudden and nonsudden cardiac death after myocardial infarction. Circulation. 1979;60:998
  4. Zareba W, Moss AJ. Noninvasive risk stratification in postinfarction patients with severe left ventricular dysfunction and methodology of the MADIT II noninvasive electrocardiology substudy. J Electrocardiol. 2003;36(Suppl):101
  5. Mäkikallio TH, Høiber S, Køber L, et al. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation. Am J Cardiol. 1999;83:836
  6. Stein PK, Barzilay JI, Chaves PHM, et al. Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study. J Cardiovascular Electrophysiology (In Press).
  7. Francis J, Watanabe MA, Schmidt G. Heart rate turbulence: a new predictor for risk of sudden cardiac death. Ann Noninvasive Electrocardiol. 2005;10:102
  8. La Rovere MT, Pinna GD, Hohnloser SH, et al. for the ATRAMI Investigators Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias. Implications for clinical trials. Circulation. 2001;103:2072
  9. Cygankiewicz I, Zareba W, Vazquez R, et al., Muerte Subita en Insuficiencia Cardiaca Investigators  Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients. Heart Rhythm. 2008;5:1095
  10. Weber S, Tillmanns H, Waldecker B. Prevalence of t wave alternans in healthy subjects. PACE. 2003;26(Pt. I):49
  11. Nieminen T, Lehtimäki T, Viik J, et al. T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. Eur Heart J. 2007;28:2332
  12. Minkkinen M, Kähönen M, Viik J, et al. Enhanced predictive power of quantitative TWA during routine exercise testing in the Finnish Cardiovascular Study. J Cardiovasc Electrophysiol. 2009;20:408
  13. Osman AF, Gold MR. T wave alternans for ventricular arrhythmia risk stratification. Curr Opin Cardiol. 2002;17:1
  14. Nearing BD, Verrier RL. Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy. J Appl Physiol. 2002;92:541
  15. Verrier RL, Kumar K, Nearing BD. Basis for sudden cardiac death prediction by T-wave alternans from an integrative physiology perspective. Heart Rhythm. 2009;6:416
  16. Sakaki K, Ikeda T, Miwa Y, et al. Time-domain T-wave alternans measured from Holter electrocardiograms predicts cardiac mortality in patients with left ventricular dysfunction: a prospective study. Heart Rhythm. 2009;6:332
  17. Stein PK, Sanghavi D, Domitrovich PP, et al. Ambulatory ECG-based T-wave alternans predicts sudden cardiac death in high-risk post-MI patients with left ventricular dysfunction in the EPHESUS study. J Cardiovascular Electrophysiol. 2008;19:1037
  18. Fried LP, Borhani NO, Enright P, et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol. 1991;1:263
  19. Kleiger RE, Stein PK, Bosner MS. Time domain measurements of heart rate variability. Cardiology Clinics of North America. 1992;10:478
  20. Rottman JN, Steinman RC, Albrecht P, Bigger JT, Rolnitzky LM, Fleiss JL. Efficient estimation of the heart period power spectrum suitable for physiologic or pharmacologic studies. Am J Cardiol. 1990;66:1522
  21. Kleiger RE, Stein PK, Bigger JT. Heart rate variability: measurement and clinical utility. A.N.E. 2005;10:1
  22. Taylor JA, Carr DL, Myers CW, Eckberg DL. Mechanisms underlying very-low-frequency RR-interval oscillations in humans. Circulation. 1998;98:547
  23. Bigger JT, Steinman RC, Rolnitzky LM, Fleiss JL, Albrecht P, Cohen RJ. Power law behavior of RR-interval variability in healthy middle-aged persons, patients with recent acute myocardial infarction, and patients with heart transplants. Circulation. 1996;93:2142
  24. Peng CK, Havlin S, Stanley HE, Goldberger AL. Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos. 1995;5:82
  25. Iyengar N, Peng CK, Morin R, Goldberger AL, Lipsitz LA. Age-related alterations in the fractal scaling of cardiac interbeat interval dynamics. Am J Physiol. 1996;271:R1078
  26. Schmidt G, Malik M, Barthel P, et al. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet. 1999;353:1390
  27. Gardin JM, Siscovick D, Anton-Culver H, et al. Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. The Cardiovascular Health Study. Circulation. 1995;15:1739
  28. Gold MR, Spencer W. T wave alternans for ventricular arrhythmia risk stratification. Curr Opin Cardiol. 2003;18:1
  29. Sandercock GRH, Brodie DA. The role of heart rate variability in prognosis for different modes of death in chronic heart failure. Pacing Clin Electrophysiol. 2006;29:892
  30. Guzzetti S, Mezzetti S, Magatelli R, et al. Linear and non-linear 24 h heart rate variability in chronic heart failure. Auton Neurosci. 2000;86:14
  31. Stein PK, Domitrovich PP, Hui N, et al. Sometimes higher heart rate variability is not better heart rate variability: results of graphical and non-linear analyses. J Cardiovasc Electrophysiol. 2005;16:1
  32. Huikuri HV, Mäkikallio TH, Peng CK, et al. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation. 2000;101:47
  33. Makikallio TH, Huikuri H, Hintze U, et al. Fractal analysis and time- and frequency-domain measures of heart rate variability as predictors of mortality in patients with heart failure. Am J Cardiol. 2001;87:178
  34. Mäkimattila S, Schlenzka A, Mäntysaari M, et al. Predictors of abnormal cardiovascular autonomic function measured by frequency domain analysis of heart rate variability and conventional tests in patients with type 1 diabetes. Diabetes Care. 2000;23:1686
  35. Goldberger AL, Amaral LAN, Glass L, et al. PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. Circulation. 2000;101:e215

 Disclosures: All authors declare no conflicts of interest and have nothing to declare financially.

PII: S0022-0736(09)00628-1

doi: 10.1016/j.jelectrocard.2009.12.009

Journal of Electrocardiology
Volume 43, Issue 3 , Pages 251-259 , May 2010