Use of Microvolt T-Wave Alternans Testing to reduce risk of sudden cardiac death Richard J. Cohen m.d. ph D Harvard-MIT Division of health Sciences and Technology
Use of Microvolt T-Wave Alternans Testing to Reduce Risk of Sudden Cardiac Deat h Richard J. Cohen M.D., Ph.D. Harvard-MIT Division of Health Sciences and Technology
Sudden cardiac death A Major Public health problem 1/2 of all cardiac deaths 1/7 of all deaths
Sudden Cardiac Death A Major Public Health Proble m • 1/2 of al l cardiac deaths • 1/7 of al l deaths
High Risk Groups for SCD Population Size SCD Percent/Year Total sCD/ Year High Coronary Risk Post mi Heart Failure EF<35%) Syncope Heart Disease Previous VEIVT 01251020 5102050 050100200300 (millions) (percent) ousan Adapted from Myerburg
(millions) (thousands) Population Size SCD Percent / Year Total SCD / Year (percent) High Risk Groups for SCD Population Size SCD Percent / Year Total SCD / Year High Cor High Coronary Risk Post M I Heart Fa Heart Failure/ E F < 35 E F < 35%) Previous VF / VT VF / VT Syncope / Heart Disease Heart Disease 012510 200125 102050 050 100200300 (millions) (percent) (thousands) Adapted from Myerburg
Heart failure Patient With "Lightheadedness A 63-year-old man arrived in the hospital for suspected VT following a bout of ightheadedness. His history revealed a diagnosis oi coronal ary artery disease, NYHA class li heart failure, previous coronary bypass graft surgery and his lvef was measured at 26%o
Heart Failure Patient With “Lightheadedness” A 63-year-old man arrived in the hospital for suspected VT followi ng a bout of lightheadedness. His history revealed a diagnosis of coronary artery disease, NYHA class II heart failure, previ ous cor onary bypass graft s u r gery, and his L VEF was measured at 26%
Patient with non-Ischemic Dilated Cardiomyopath A 54-year-old woman arrived in the hospital following a syncopal episode her history revealed diagnoses of non-ischemic dilated cardiomyopathy, NYHA class I heart failure and a previously measured lvef was 25%0
Patient with Non-Ischemic Dilated Cardiomyopathy A 54-year-old woman arrived in the hospital following a syncopal episode. Her history revealed diagnoses of non-ischemic dilated cardiomyopathy, NYHA class I heart failure, and a previously measured LVEF was 25%