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

Measurement of microvolt level T-wave alternans in the surface electrocardi ogram Is a novel way to assess the risk of ventricular arrhythmias. Seven t aste of arrhythmic risk, including T-wave alternans, were undertaken in 107 consecutive patients with congestive heart failure and no history of susta ined ventricular arrhythmias; the patients were followed up for arrhythmic events during the next 18 months. Of the patients with events, 11 had posit ive and two indeterminate T-wave alternans results; there ware no arrhythmi c events among patients with negative T-wave alternans results. Of the seve n tests, only T-wave alternans was a significant (p=0.0036) and independent predictor of arrhythmic events.