心肌梗死患者心脏性猝死危险分层研究
|
摘要
目的：本研究旨在评价多项无创心电学指标：T波电交替(TWA)、窦性心率震荡(HRT)、心率变异性(HRV)、非持续性室速(NSVT)、室性早搏(VPBs)、心室晚电位(VLP)、QT司期(QTc),在心肌梗死早期作为心脏性猝死(SCD)预测因子的预测价值,并探索理想的联合方案,识别心肌梗死后猝死高危人群。方法：连续入选我院CCU病房289例急性心肌梗死患者,心肌梗死急性期(2周内)给予常规12导联体表心电图、平均信号心电图及动态心电图检查。体表心电图测定QRS波宽度和QTc间期：QRS波增宽定义为QRS波宽度>110ms,QTc延长定义为QTc间期>450ms(男性)/460ms(女性)；心室晚电位(VLP)是应用正交Frank导联系统滤波后矢量值的时域测量法测定(GE公司MAC5000),阳性标准为：RMS40<20μV+f-QRS)>114ms和/或LAS40>38ms;动态心电图测定：TWA、HRT、HRV;计算机软件应用改良的修正平均心搏(modified moving average MMA)算法来识别动态心电图记录期内存在的TWA,采用TWA≥47μV为界点；HRT异常定义为TO异常或/TS异常；HRV异常定义为SDNN<70ms;同时动态心电图可以记录室性早搏(30次/小时为频发)和非持续性室速(连续3个以上室性早搏,且心率大于100次/分)；二维超声心动图测LVEF值,心功能下降定义为LVEF随访一级终点为心脏性猝死或致死性室性心律失常,全因死亡和非心律失常性心脏性死亡为二级终点。
结果：平均随访11±3月,期间有15例(5%)患者发生SCD。与幸存组患者相比,SCD组患者LVEF明显低[35%(28%-52%) vs50%(33%-60%), P<0.0001], QRS波宽度明显较长[115(88-152)ms vs105(91-136)ms, P=0.022],而QTc间期无显著差异[458(416-513)ms vs450(394-493)ms, P=0.183]; COX多因素分析：显示TWA、VLP、HRT (TS)及NSVT对心脏性猝死具有预测价值,风险比分别为：15.07(95%可信区间,2.88～78.68；p=0.001)；6.49(95%可信区间,2.13～19.77；p=0.0031)、4.21(95%可信区间,1.18-14.99；p=0.026)及16.78(95%可信区间,3.68～44.41；p<0.0001)。且24小时内发生T波电交替(≥47μ V)的频次超过5次的患者发生SCD的风险更高,其风险比为18.24(95%可信区间,4.20-83.68；p=0.0004)。联合NSVT或TS可提高VLP预测能力,风险比由6.49分别提高到16.07及14.21。
结论：心肌梗死急性期(2周内)出现NSVT或TWA≥47μV且发生频次≥5次/24h的患者发生SCD的风险较大；阳性VLP同时伴有异常TS或NSVT能够识别发生心脏性猝死的高危患者。
OBJECTIVES:The purpose of this study was to assess a number of non-invasive cardiac electrical indicators (TWA, HRV, HRT, NSVT, VPBs, VLP, QTc) to identify AMI patients at increased risk for SCD, and designed to evaluate the value of all indicators as predictors of SCD in the early post MI period and to find the optimal way to combine and use these noninvasive techniques in clinical practice.
METHODS:289consecutive post-MI patients were enrolled in the study. Body electrocardiograph, Ambulatory ECG-based measures and signal-averaged electrocardiography were performed within2weeks after AMI. The duration of QRS wave and the QTc interval were measured by body electrocardiograph. The wide QRS wave was defined as its duration longer than110ms. The extended QTc interval was defined as its value longer than450ms for male or460ms for female. The analysis of VLP is based on the quantitative time-domain measurements of the filtered vector magnitude of the orthogonal Frank X, Y, and Z leads. VLP were considered to be present when the three criteria (RMS40≤20mV+f-QRS≥114ms, and/or LAS40≥38ms) were met. We analyzed hazard ratios using the previously determined47μV TWA cutpoint. Impaired HRT was defined by abnormalities in either HRT onset (TO value of>0) or slope (TS value of<2.5ms/per normal-to-normal interval).The standard deviation of all normal-to-normal R-R intervals (SDNN) was chosen as a parameter of HRV in this study, and a value of<70ms was pre-defined as abnormal. VPBs (30or more VPBs per hour) and NSVT (≥3consecutive ventricular premature beats at a rate of100beats/min) were also recorded by an ambulatory ECG. The left ventricular dysfunction was defined as LVEF lower than35%. The primary outcome was prospectively defined as sudden cardiac death or life-threatening ventricular arrhythmic events. All cause mortality and cardiac deaths categorized as nonarrhythmic were secondary outcomes.
RESULTS:The duration of follow-up was11±3months.15(5%) patients died suddenly. Compared to the patients in survived group, the patient with SCD had lower LVEF[35%(28%-52%) vs50%(33%-60%), P<0.0001], longer duration of QRS wave[115(88,152)ms vs105(91,136)ms, P=0.0222] and longer QTc interval [458(416,513)ms vs450(394,493)ms, P=0.1836]. Multivariate Cox Regression Analyses showed that an ambulatory ECG-based TWA, VLP, TS and present NSVT were predictors of the primary outcome. A hazard ratio for TWA was15.07(95%CI2.88to78.68; p=0.001), for VLP was6.49(95%CI2.13to19.77; p=0.0031), for TS was4.21(95%CI1.18to14.99; p=0.026) and for NSVT was16.78(95%CI3.68to44.41; p<0.0001). Moreover, patients with≥5TWA episodes≥47μV were at higher risk for SCD [Hazard ratio=18.24(95%CI,4.20to83.68), p=0.0004]. United TWA and TS can improve VLP predictive capability, the hazard ratio (HR), respectively, from6.49to16.07and14.21.
CONCLUSIONS:TWA (≥47μV) monitored within2weeks after AMI predicted heightened risk of SCD. Prediction is improved when the frequency of TWA episodes≥47μV is analyzed. Patients were found to be at the higher risk if they met the both positive VLP and TS or TWA.
结果：平均随访11±3月,期间有15例(5%)患者发生SCD。与幸存组患者相比,SCD组患者LVEF明显低[35%(28%-52%) vs50%(33%-60%), P<0.0001], QRS波宽度明显较长[115(88-152)ms vs105(91-136)ms, P=0.022],而QTc间期无显著差异[458(416-513)ms vs450(394-493)ms, P=0.183]; COX多因素分析：显示TWA、VLP、HRT (TS)及NSVT对心脏性猝死具有预测价值,风险比分别为：15.07(95%可信区间,2.88～78.68；p=0.001)；6.49(95%可信区间,2.13～19.77；p=0.0031)、4.21(95%可信区间,1.18-14.99；p=0.026)及16.78(95%可信区间,3.68～44.41；p<0.0001)。且24小时内发生T波电交替(≥47μ V)的频次超过5次的患者发生SCD的风险更高,其风险比为18.24(95%可信区间,4.20-83.68；p=0.0004)。联合NSVT或TS可提高VLP预测能力,风险比由6.49分别提高到16.07及14.21。
结论：心肌梗死急性期(2周内)出现NSVT或TWA≥47μV且发生频次≥5次/24h的患者发生SCD的风险较大；阳性VLP同时伴有异常TS或NSVT能够识别发生心脏性猝死的高危患者。
OBJECTIVES:The purpose of this study was to assess a number of non-invasive cardiac electrical indicators (TWA, HRV, HRT, NSVT, VPBs, VLP, QTc) to identify AMI patients at increased risk for SCD, and designed to evaluate the value of all indicators as predictors of SCD in the early post MI period and to find the optimal way to combine and use these noninvasive techniques in clinical practice.
METHODS:289consecutive post-MI patients were enrolled in the study. Body electrocardiograph, Ambulatory ECG-based measures and signal-averaged electrocardiography were performed within2weeks after AMI. The duration of QRS wave and the QTc interval were measured by body electrocardiograph. The wide QRS wave was defined as its duration longer than110ms. The extended QTc interval was defined as its value longer than450ms for male or460ms for female. The analysis of VLP is based on the quantitative time-domain measurements of the filtered vector magnitude of the orthogonal Frank X, Y, and Z leads. VLP were considered to be present when the three criteria (RMS40≤20mV+f-QRS≥114ms, and/or LAS40≥38ms) were met. We analyzed hazard ratios using the previously determined47μV TWA cutpoint. Impaired HRT was defined by abnormalities in either HRT onset (TO value of>0) or slope (TS value of<2.5ms/per normal-to-normal interval).The standard deviation of all normal-to-normal R-R intervals (SDNN) was chosen as a parameter of HRV in this study, and a value of<70ms was pre-defined as abnormal. VPBs (30or more VPBs per hour) and NSVT (≥3consecutive ventricular premature beats at a rate of100beats/min) were also recorded by an ambulatory ECG. The left ventricular dysfunction was defined as LVEF lower than35%. The primary outcome was prospectively defined as sudden cardiac death or life-threatening ventricular arrhythmic events. All cause mortality and cardiac deaths categorized as nonarrhythmic were secondary outcomes.
RESULTS:The duration of follow-up was11±3months.15(5%) patients died suddenly. Compared to the patients in survived group, the patient with SCD had lower LVEF[35%(28%-52%) vs50%(33%-60%), P<0.0001], longer duration of QRS wave[115(88,152)ms vs105(91,136)ms, P=0.0222] and longer QTc interval [458(416,513)ms vs450(394,493)ms, P=0.1836]. Multivariate Cox Regression Analyses showed that an ambulatory ECG-based TWA, VLP, TS and present NSVT were predictors of the primary outcome. A hazard ratio for TWA was15.07(95%CI2.88to78.68; p=0.001), for VLP was6.49(95%CI2.13to19.77; p=0.0031), for TS was4.21(95%CI1.18to14.99; p=0.026) and for NSVT was16.78(95%CI3.68to44.41; p<0.0001). Moreover, patients with≥5TWA episodes≥47μV were at higher risk for SCD [Hazard ratio=18.24(95%CI,4.20to83.68), p=0.0004]. United TWA and TS can improve VLP predictive capability, the hazard ratio (HR), respectively, from6.49to16.07and14.21.
CONCLUSIONS:TWA (≥47μV) monitored within2weeks after AMI predicted heightened risk of SCD. Prediction is improved when the frequency of TWA episodes≥47μV is analyzed. Patients were found to be at the higher risk if they met the both positive VLP and TS or TWA.
引文
[1]Turakhia M, Tseng ZH. Sudden cardiac death:epidmiology, mech— anisms, and therapy. Curt Probl Cardiol.2007;32:501-511
[2]Bayes de luna A, Coumel P, Leclerq JF, Ambulatory sudden cardiac death:mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J.1989;117:115-159.
[3]Rouleau JL, Talajic M, Sussex B, et al. Myocardial infarction patients in the 1990s--their risk factors, stratification and survival in Canada:the Canadian Assessment of Myocardial Infarction (CAMI) Study. J Am Coll Cardiol.1996 Apr; 27(5):1119-1127
[4]Podrid PJ, Myerburg RJ. Epidemiology and stratification of risk for sudden cardiac death. Clin Cardiol.2005; 28(11 Suppl 1):3-11.
[5]Bigger JT Jr, Fleiss JL, Kleiger R, et al. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction.Circulation 1984; 69:250-258
[6]Richards DA, Byth K, Ross DL, et al. What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction? Circulation. 1991;83(3):756-763.
[7]Steinberg JS, Regan A, Sciacca RR, et al. Predicting arrhythmic events after acute myocardial infarction using the signal-averaged electrocardiogram. Am J Cardiol. 1992; 69(1):13-21.
[8]Windhagen-Mahnert B, Kadish AH. Application of noninvasive and invasive tests for risk assessment in patients with ventricular arrhythmias. Cardiol Clin.2000; 18(2):243-263.
[9]Bailey JJ, Berson AS, Handelsman H, et al. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol.2001; 38(7):1902-1911.
[10]Shamim W, Francis DP, Yousufuddin M, et al. Intraventricular conduction delay:a prognostic marker in chronic heart failure. Int J Cardiol 1999; 70:171-178.
[11]Buxton AE, Sweeney MO, Wathen MS, et al., PainFREE Rx Ⅱ Investigators. QRS duration does not predict occurrence of ventricular tachyarrhythmias in patients with implanted cardioverter-defibrillators. J Am Coll Cardiol 2005; 46:310-316.
[12]Singh JP, Hall WJ, McNitt S, et al., MADIT-Ⅱ Investigators. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation: findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol 2005; 46:1712-1720.
[13]Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction:results from a cohort of 2265 patients with an ejection fraction of_ or _40%. Am Heart J 2003; 145:132-8.
[14]Gang Y, Ono T, Hnatkova K, et al., ELITE Ⅱ Investigators. QT dispersion has no prognostic value in patients with symptomatic heart failure:an ELITE Ⅱ substudy. Pacing Clin Electrophysiol 2003;26:394-400.
[15]Brendorp B, Elming H, Jun L, et al., Diamond Study Group. QTc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide. Circulation 2001; 103:1422-7.
[16]Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999;34:912-48.
[17]Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991;68:887-96.
[18]Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996;94:3198-203.
[19]Camm AJ, Pratt CM, Schwartz PJ, et al., AzimiLide post Infarct surVival Evaluation (ALIVE) Investigators. Mortality in patients after a recent myocardial infarction:a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification. Circulation 2004; 109:990-6.
[20]Hohnloser SH, Kuck KH, Dorian P, et al., DINAMIT Investigators. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med.2004; 351:2481-8.
[21]Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-30.
[22]Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003; 67: 601-4.
[23]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;353:1390-6.
[24]Pham Q, Quan KJ, Rosenbaum DS. T-wave alternans:marker, mechanism, and methodology for predicting sudden cardiac death. J Electrocardiol.2003;36:75-81.
[25]Estes NA 3rd, Michaud G, Zipes DP, et al. Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. Am J Cardiol.1997; 80(10):1314-8.
[26]Goldberger, Cain, Hohnloser, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. J Am Coll Cardiol,2008; 52: 1179-1199.
[27]Myerburg RJ, Mitrani R, Interian A Jr., Castellanos A. Interpretation of outcomes of antiarrhythmic clinical trials:design features and population impact. Circulation 1998; 97:1514-1521.
[28]Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV:the ST segment, T and U waves, and the QT interval:a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol,2009,53:982-991.
[29]. Cain ME, Anderson JL, Ansdorf MF, et al. ACC Expert Consensus Document: signal-averaged electrocardiography. J Am Coll Cardiol,1996; 27:238-249.
[30]Nearing BD, Oesterle SN, Verrier RL. Quantification of ischaemia induced vulnerability by precordial T wave alternans analysis in dog and human. Cardiovascular Res 1994;28:1440.
[31]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;353:1390-1396.
[32]Barthel P, Schneider R, Bauer A et al. Risk stratification after acute myocardial infarction by heart rate turbulence. Circulation,2003;108:1221-1226.
[33]Tapanainen JM, Still A-M, Airaksinen KEJ et al. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction: results of a prospective follow-up study. J Cardiovasc Electrophysiol,2001; 12: 645-652.
[34]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. Circulation,2001; 103:2072-2077
[35]The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983;309:331.
[36]Moss AJ, Hall WJ, Cannom DS. Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996;335:1933.
[37]Bardy GH, Lee KL, Mark DB. Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225.
[38]Kadish A, Dyer A, Daubert JP. Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151.
[39]Singh JP, Hall WJ, McNitt S, et al. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation:findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol,2005,46:1712-1720.
[40]Kashani A, Barold SS. Significance of QRS complex duration in patients with heart failure. J Am Coll Cardiol,2005,46:2183-2192.
[41]Goldberger JJ, Cain ME, Hohnloser SH, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. J Am Coll Cardiol, 2008,52:1179-1199.
[42]Tabrizi F, Englund A, Rosenqvist M, et al. Influence of left bundle branch block on long-term mortality in a population with heart failure. Eur Heart J,2007,28: 2449-2455.
[43]Barsheshet A, Goldenberg I, Garty M, et al. Relation of bundle branch block to long-term (four-year) mortality in hospitalized patients with systolic heart failure. Am J Cardiol,2011,107:540-544.
[44]Dekker JM, Crow RS, Hannan PJ, et al. Heart rate-corrected QT interval prolongation predicts risk of coronary heart disease in black and white middle-aged men and women:the ARIC study. J Am Coll Cardiol,2004,43:565-571.
[45]Davey P. QT interval and mortality from coronary artery disease. Prog Cardiovasc Dis,2000,42:359-384.
[46]Selker HP, Raitt MH, Schmid CH, et al. Time-dependent predictors of primary cardiac arrest in patients with acute myocardial infarction. Am J Cardiol,2003,91: 280-286.
[47]Kabakci G, Onalan O, Batur MK, et al. What is the optimal evaluation time of the QT dispersion after acute myocardial infarction for the risk stratification? Angiology, 2001,52:463-468.
[48]Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV:the ST segment, T and U waves, and the QT interval:a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol,2009,53:982-991
[49]Kuchar DL, Thorburn CW, Sammel NL. Late potentials detected after myocardial infarction:natural history and prognostic significance. Circulation. 1986;74:1280-1289.
[50]Hartikainen JEK, Malik M, Staunton A, et al. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
[51]Pogwizd SM, Hoyt RH, Saffitz JE, Corr PB, Cox JL, Cain ME. Reentrant and focal mechanisms underlying ventricular tachycardia in the human heart. Circulation 1992;86:1872-87.
[52]Hood MA, Pogwizd SM, Peirick J, Cain ME. Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs. Circulation 1992;86:1888-901.
[53]Reinhardt L, Makijarvi M, Fetsch T, et al. Predictive value of wavelet correlation functions of signal-averaged electrocardiogram in patients after anterior versus inferior myocardial infarction. J Am Coll Cardiol 1996;27:53-9.
[54]Vazquez R, Caref EB, Torres F, Reina M, Guerrero JA, El-Sherif N. Reproducibility of time-domain and three different frequency-domain techniques for the analysis of the signal-averaged electrocardiogram. J Electrocardiol 2000;33:99-105.
[55]Gottfridsson C, Karlsson T, Edvardsson N. The short-term and long-term reproducibility of spectral turbulence and late potential variables of the signal-averaged ECG in a population sample of healthy subjects and the impact of gender, age, and noise. J Electrocardiol 2000;33:107-17.
[56]Bloomfield DM, Snyder JE, Steinberg JS. A critical appraisal of quantitative spectro-temporal analysis of the signal-averaged ECG:predicting arrhythmic events after myocardial infarction. Pacing Clin Electrophysiol 1996; 19:768-77.
[57]Kavesh NG, Cain ME, Ambos HD, Arthur RM. Enhanced detection of distinguishing features in signal-averaged electrocardiograms from patients with ventricular tachycardia by combined spatial and spectral analyses of entire cardiac cycle. Circulation 1994;90:254-63.
[58]Vazquez R, Caref EB, Torres F, Reina M, Ortega F, el-Sherif N. Short-term reproducibility of time domain, spectral temporal mapping, and spectral turbulence analysis of the signal-averaged electrocardiogram in normal subjects and patients with acute myocardial infarction. Am Heart J 1995;130:1011-9.
[59]Englund A, Andersson M, Bergfeldt L. Spectral turbulence analysis of the signal-averaged electrocardiogram for predicting inducible sustained monomorphic ventricular tachycardia in patients with and without bundle branch block. Eur Heart J 1995;16:1936-42.
[60]Huikuri HV, Tapanainen JM, Lindgren K, et al. Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era. J Am Coll Cardiol 2003; 42:652-8.
[61]Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001; 24:789-95.
[62]Steinbigler P, Haberl R, Bruggemann T, Andresen D, Steinbeck G. Postinfarction risk assessment for sudden cardiac death using late potential analysis of the digital Holter electrocardiogram. J Cardiovasc Electrophysiol 2002; 13:1227-32.
[63]Ikeda T, Sakata T, Takami M, et al. Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction. A prospective study. J Am Coll Cardiol 2000; 35:722-30.
[64]Touboul P, Andre-Fouet X, Leizorovicz A, et al., The Groupe d'Etude du Pronostic de 1'Infarctus du Myocarde (GREPI). Risk stratification after myocardial infarction. A reappraisal in the era of thrombolysis. Eur Heart J 1997; 18:99-107.
[65]Kawalsky DL, Garratt KN, Hammill SC, Bailey KR, Gersh BJ. Effect of infarct-related artery patency and late potentials on late mortality after acute myocardial infarction. Mayo Clin Proc 1997; 72:414-21.
[66]Hartikainen JE, Malik M, Staunton A, Poloniecki J, Camm AJ. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
[67]Steinberg JS, Hochman JS, Morgan CD, et al. Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG. Results of a multicenter randomized trial. LATE Ancillary Study Investigators. Late Assessment of Thrombolytic Efficacy. Circulation 1994; 90:746-52.
[68]Evrengul H, Dursunoglu D, Kayikcioglu M, et al. Effects of a betablocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving successful thrombolytic therapy. Jpn Heart J 2004; 45:11-21.
[69]Karam C, Golmard J, Steg PG. Decreased prevalence of late potentials with mechanical versus thrombolysis-induced reperfusion in acute myocardial infarction. J Am Coll Cardiol 1996; 27:1343-8.
[70]Denes P, el-Sherif N, Katz R, et al., Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Am J Cardiol 1994;74:216-20.
[71]Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001; 38:1902-11.
[72]Savard P, Rouleau JL, Ferguson J, et al. Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 1997;96:202-13.
[73]Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001; 24:789-95.
[74]Hofmann T, Burmeister A, Meinertz T. Prognostic significance of the signal averaged electrocardiogram in patients with chronic stable coronary artery disease: analysis in the time domain and by spectral temporal mapping. Z Kardiol 2004; 93:32-42.
[75]Gomes JA, Cain ME, Buxton AE, Josephson ME, Lee KL, Hafley GE. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Circulation 2001;104:436-41.
[76]Gold MR, Bloomfield DM, Anderson KP, et al. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 2000; 36:2247-53.
[77]Bigger JT Jr., Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. N Engl J Med 1997;337:1569-75.
[78]Bigger JT Jr., Whang W, Rottman JN, et al. Mechanisms of death in the CABG Patch trial:a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. Circulation 1999; 99:1416-21.
[79]Scharf C, Redecker H, Duru F, et al. Sudden cardiac death after coronary artery bypass grafting is not predicted by signal-averaged ECG. Ann Thorac Surg 2001; 72:1546-51.
[80]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;353:1390-1396.
[81]Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-330.
[82]Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003; 67:601-604.
[83]Reinfrnrdt L, M&ij&vi M, Fetsch T, Martirrez-Rrrbio A, Biicker D, Block M, Borggrefe M, Breithardt G. Reduced beat-to-beat changes of heart rate:an important risk factor after myocardial infarction. Cardiology,1996; 87:104-111.
[84]La Rovere MT, Bigger JT, Marcus FI, et al. Baroreflex sensitivity and heart rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet, 1998; 351:478-484.
[85]El-Sherif N, Denes P, Katz R, et al. Definition of the best prediction criteria of the time-domain signal-averaged electrocardiogram for serious arrhythmic events in the post-infarction period. J Am Coll Cardiol,1995; 25:908-914.
[86]Gomes JA, Winters SL, Martinson M, et al. The prognostic significance of quantitative signal-averaged variables relative to clinical variables, site of myocardial infarction, ejection fraction and ventricular premature beats:a prospective study. J Am Coll Cardiol,1988; 13:377-384.
[87]J. Anthony Gomes, Michael E. Cain, Alfred E. Buxton, Mark E. Josephson, Kerry L. Lee and Gail E. Hafley. Prediction of Long-Term Outcomes by Signal-Averaged Electrocardiography in Patients With Unsustained Ventricular Tachycardia, Coronary Artery Disease, and Left Ventricular Dysfunction. Circulation, 2001; 104:436-441
[88]Copie X, Hnatkova K, Staunton A, et al. Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction:Results of a two-year follow-up study. J Am Coll Cardiol 1996; 27:270-276.
[89]Gomes JA, Winters SL, Stewart D, et al. A new non-invasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction:Based on signal-averaged electrocardiogram, radionuclide ejection fraction, and Holter monitoring. J Am Coll Cardiol 1987; 10:349-357.
[90]Kuchar DL, Thornburn CW, Sammel NL. Prediction of serious arrhythmic events after myocardial infarction:Signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol 1987; 9:531-538.
[91]Barron HV, Viskin S. Autonomic markers and prediction of cardiac death after myocardial infarction. Lancet,1998; 351:461-462.
[92]Cain ME, Anderson JL, Ansdorf MF, et al. ACC Expert Consensus Document: signal-averaged electrocardiography. J Am Coll Cardiol,1996; 27:238-249.
[93]Reinhardt L, Makijarvi M, Fetsch T, et al. Noninvasive risk modeling after myocardial infarction. Am J Cardiol 1996; 78:627-32.
[94]Bonnemeier H, Wiegand UK, Friedlbinder J, Schulenburg S, Hartmann F, Bode F, Katus HA, Richardt G. Reflex cardiac activity in ischemia and reperfusion:heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Circulation,2003; 108:958-964.
[95]Sade E, Aytemir K, Oto A, Nazli N, Ozmen F, Ozkutlu H, Tokgozoglu L, Aksoyek S, Ovunc K, Kabakci G, Ozer N, Kes S. Assessment of heart rate turbulence in the acute phase of myocardial infarction for long-term prognosis. Pacing Clin Electrophysiol.2003; 26:544-50.
[96]Walker ML, Rosenbaum DS. Repolarization alternans:implications for the mechanism and prevention of sudden cardiac death. Cardiovasc Res 2003; 57:599-614.
[97]Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation 1999; 99:1385-94.
[98]Verrier RL, Nearing BD, La Rovere MT, Pinna GD, Mittleman MA, Bigger JT, Schwartz PJ. Ambulatory electrocardiogram-based tracking of T-wave alternans in postmyocardial infarction patients to assess risk of cardiac arrest or arrhythmic death. J Cardiovasc Electrophysiol 2003;14:705.
[99]Stein P, Sanghavi D, Domitrovich P, Mackey RA, Deedwania P. 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 Cardiovasc Electrophysiol 2008; 19:1037.
[100]Stein PK, Sanghavi D, Sotoodehnia N, Siscovick DS, Gottdiener J. Association of Holter-based measures including T-wave alternans with risk of sudden cardiac death in the community-dwelling elderly:the Cardiovascular Health Study. J Electrocardiol 2010;43:251.
[101]Sakaki K, Ikeda T, Miwa Y, Miyakoshi M, Abe A, Tsukada T, Ishiguro H, Mera H, Yusu S, Yoshino H. 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.
[102]Gehi AK, Stein RH, Metz LD, Gomes JA. Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events:a metaanalysis. J Am Coll Cardiol 2005; 46:75-82.
[103]Verrier, Klingenheben, Malik, El-Sherif, Exner, Hohnloser, Ikeda, Narayan, Nieminen, Rosenbaum. Microvolt T-Wave Alternans Physiological Basis, Methods of Measurement, and Clinical Utility—Consensus Guideline by International Society for Holter and Noninvasive Electrocardiology. JACC 2011;58:1309-1324
[104]Nieminen T, Lehtimaki T, Viik J, Lehtinen R, Nikus K, Koobi T, Niemela K, Turjanmaa V, Kaiser W, Huhtala H, Verrier RL, Huikuri H, Kahonen M. T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. Eur Heart J 2007; 28:2332.
[105]Exner DV, Kavanagh KM, Slawnych MP, Mitchell LB, Ramadan D, Aggarwal SG, Noullett C, Schaik AV, Mitchell RT, Shibata MA, Gulamhussein S, McMeekin J, Tymchak W, Schnell G, Gillis AM, Sheldon RS, Fick GH, Duff HJI. Noninvasive risk assessment early after a myocardial infarction:The REFINE Study. J Am Coll Cardiol 2007; 50:2275.
[106]Tapanainen JM, Still AM, Airaksinen KE, Huikuri HV. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction:Results of a prospective follow-up study. J Cardiovasc Electrophysiol 2001; 12:645.
[107]Solomon SD, Zelenkofske S, McMurray JJ, Finn PV, Velazquez E, Ertl G Harsanyi A, Rouleau JL, Maggioni A, Kober L, White H, Werf FV, Pieper K,Califf RM, Pfeffer MA. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both, N Engl J Med 2005;352:2581.
[108]Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999; 34:912-48.
[109]Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69:250-8.
[110]The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983; 309:331-6.
[111]Kotler MN, Tabatznik B, Mower MM, Tominaga S. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation 1973; 47:959-66.
[112]Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy:prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985;55:146-51.
[113]Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991; 68:887-96.
[114]Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996; 94:3198-203.
[115]McClements BM, Adgey AA. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute infarction in the thrombolytic era. J Am Coll Cardiol 1993; 21:1419-27.
[116]Hohnloser SH, Franck P, Klingenheben T, Zabel M, Just H. Open infarct artery, late potentials, and other prognostic factors in patients after acute myocardial infarction in the thrombolytic era. A prospective trial. Circulation 1994;90:1747-56.
[117]Cairns JA, Connolly SJ, Roberts R, Gent M, Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations:CAMIAT. Lancet 1997;349:675-82.
[118]Maggioni AP, Zuanetti G, Franzosi MG, et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993; 87:312-22.
[119]Julian DG, Camm AJ, Frangin G, et al., European Myocardial Infarct Amiodarone Trial Investigators. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction:EMIAT. Lancet 1997; 349:667-74.
[120]Kron J, Hart M, Schual-Berke S, Niles NR, Hosenpud JD, McAnulty JH. Idiopathic dilated cardiomyopathy. Role of programmed electrical stimulation and Holter monitoring in predicting those at risk of sudden death. Chest 1988; 93:85-90.
[121]Huang SK, Messer JV, Denes P. Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy:observations in 35 patients. Am J Cardiol 1983;51:507-12.
[122]Ikegawa T, Chino M, Hasegawa H, et al. Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study. Clin Cardiol 1987;10:78-82.
[123]Pelliccia F, Gallo P, Cianfrocca C, d'Amati G, Bernucci P, Reale A. Relation of complex ventricular arrhythmias to presenting features and prognosis in dilated cardiomyopathy. Int J Cardiol 1990; 29:47-54.
[124]Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984; 54:147-52.
[125]The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. The preliminary report:effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989; 321:406-12.
[126]Ikeda T, Saito H, Tanno K, Shimizu H, Watanabe J, Ohnishi Y, Kasamaki Y, Ozawa Y.T-wave alternans as a predictor for sudden cardiac death after myocardial infarction. Am J Cardiol.2002; 89(1):79-82.
[127]Kuchar DL, Thorburn CW, Sammel NL.Prediction of serious arrhythmic events after myocardial infarction:signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol,1987; 9(3):531-538
[128]Perkiomaki JS, Hamekoski S, Junttila MJ, Jokinen V, Tapanainen J, Huikuri HV. Predictors of long-term risk for heart failure hospitalization after acute myocardial infarction.Ann Noninvasive Electrocardiol.2010; 15(3):250-8.
1. Pratt CM, Greenway PS, Schoenfeld MH, Hibben ML, Reiffel JA. Exploration of the precision of classifying sudden cardiac death:implications for the interpretation of clinical trials. Circulation 1996;93:519-524.
2. Goldberger JJ, Weinberg KM, Kadish AH. Impact of nontraditional antiarrhythmic drugs on sudden cardiac death. In:Zipes D, Jalife J, editors. Cardiac Electrophysiology:From Cell to Bedside.4th ed. Philadelphia, PA:WB Saunders, 2004:950-958.
3. Myerburg RJ, Mitrani R, Interian A Jr., Castellanos A. Interpretation of outcomes of antiarrhythmic clinical trials:design features and population impact. Circulation 1998;97:1514-1521.
4. Heller RF, Chinn S, Pedoe HD, Rose G. How well can we predict coronary heart disease? Findings in the United Kingdom Heart Disease Prevention Project. Br Med J (Clin Res Ed) 1984;288:1409-11.
5. Rose GA. The Strategy of Preventive Medicine. Oxford, UK:Oxford University Press,1992.
6. Wackers FJ, Berger HJ, Johnstone DE, et al. Multiple gated cardiac blood pool imaging for left ventricular ejection fraction:validation of the technique and assessment of variability. Am J Cardiol 1979;43:1159-66.
7. McGowan JH, Cleland JG. Reliability of reporting left ventricular systolic function by echocardiography:a systematic review of 3 methods. Am Heart J 2003;146:388-97.
8. Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984;69:250-8.
9. Sanz G, Castaner A. Betriu A, et al. Determinants of prognosis in survivors of myocardial infarction:a prospective clinical angiographic study. N Engl J Med 1982;306:1065-70.
10. The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983;309:331-6.
11. Volpi A, De Vita C, Franzosi MG, et al. Determinants of 6-month mortality in survivors of myocardial infarction after thrombolysis:results of the GISSI-2 data base: the Ad hoc Working Group of the Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI)-2 Data Base. Circulation 1993;88:416-29.
12. Huikuri HV, Tapanainen JM, Lindgren K, et al. Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era. J Am Coll Cardiol 2003;42:652-8.
13. McClements BM, Adgey AA. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute infarction in the thrombolytic era. J Am Coll Cardiol 1993;21:1419-27.
14. Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001;38:1902-11.
15. Hohnloser SH, Kuck KH, Dorian P, et al., DINAMIT Investigators. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med 2004;351:2481-8.
16. Solomon SD, Zelenkofske S, McMurray JJ, et al., Valsartan in Acute Myocardial Infarction Trial (VALIANT) Investigators. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med 2005;352:2581-8.
17. Bigger JT Jr., Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. N Engl J Med 1997;337:1569-75.
18. Moss AJ, Hall WJ, Cannom DS, et al. Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996;335:1933-40.
19. Moss AJ,Fadl Y, Zareba W. Cannom DS, Hall WJ, Defibrillator Implantation Trial Research Group. Survival benefit with an implanted defibrillator in relation to mortality risk in chronic coronary heart disease. Am J Cardiol 2001;88:516-20.
20. Buxton AE, Lee KL, Hafley GE, et al., MUSTT Investigators. Relation of ejection fraction and inducible ventricular tachycardia to mode of death in patients with coronary artery disease:an analysis of patients enrolled in the Multicenter Unsustained Tachycardia Trial. Circulation 2002; 106:2466-72.
21. Moss AJ, Zareba W, Hall WJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877-83.
22. Bardy GH, Lee KL, Mark DB, et al., Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225-37.
23. Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med 1994;331:1564-75.
24. Grimm W, Christ M, Bach J, Muller HH, Maisch B. Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy:results of the Marburg cardiomyopathy study. Circulation 2003; 108:2883-91.
25. Kadish A, Dyer A, Daubert JP, et al., Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151-8.
26. Shamim W, Yousufuddin M, Cicoria M, Gibson DG, Coats AJ, Henein MY. Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure. Heart 2002;88:47-51.
27. Desai AD, Yaw TS, Yamazaki T, Kaykha A, Chun S, Froelicher VF. Prognostic significance of quantitative QRS duration. Am J Med 2006; 119:600-6.
28. Nichol G, Kaul P, Huszti E, Bridges JF. Cost-effectiveness of cardiac resynchronization therapy in patients with symptomatic heart failure. Ann Intern Med 2004; 141:343-51.
29. Shamim W, Francis DP, Yousufuddin M, et al. Intraventricular conduction delay:a prognostic marker in chronic heart failure. Int J Cardiol 1999;70:171-8.
30. Park RC, Little WC, O'Rourke RA. Effect of alteration of left ventricular activation sequence on the left ventricular end-systolic pressurevolume relation in closed-chest dogs. Circ Res 1985;57:706-17.
31. Vassallo JA, Cassidy DM, Miller JM, Buxton AE, Marchlinski FE, Josephson ME. Left ventricular endocardial activation during right ventricular pacing:effect of underlying heart disease. J Am Coll Cardiol 1986;7:1228-33.
32. Akar FG, Spragg DD, Tunin RS, Kass DA, Tomaselli GF. Mechanisms underlying conduction slowing and arrhythmogenesis in nonischemic dilated cardiomyopathy. Circ Res 2004;95:717-25.
33. Freedman RA, Alderman EL, Sheffield LT, Saporito M, Fisher LD. Bundle branch block in patients with chronic coronary artery disease:angiographic correlates and prognostic significance. J Am Coll Cardiol 1987; 10:73-80.
34. McCullough PA, Philbin EF, Spertus JA, Kaatz S, Sandberg KR, Weaver WD. Resource Utilization Among Congestive Heart Failure (REACH) Study. Confirmation of a heart failure epidemic:findings from the Resource Utilization Among Congestive Heart Failure (REACH) study. J Am Coll Cardiol 2002;39:60-9.
35. Baldasseroni S, Opasich C, Gorini M, et al., Italian Network on Congestive Heart Failure Investigators. Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: a report from the Italian network on congestive heart failure. Am Heart J 2002;143:398-405.
36. Iuliano S, Fisher SG, Karasik PE, Fletcher RD, Singh SN. Department of Veterans Affairs Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. QRS duration and mortality in patients with congestive heart failure. Am Heart J 2002;143:1085-91.
37. Greenberg H, Case RB, Moss AJ, Brown MW, Carroll ER, Andrews ML, MADIT-Ⅱ Investigators. Analysis of mortality events in the Multicenter Automatic Defibrillator Implantation Trial (MADIT-Ⅱ). J Am Coll Cardiol 2004;43:1459-65.
38. Moss AJ, Zareba W, Hall WJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877-83.
39. Zimetbaum PJ, Buxton AE, Batsford W, et al. Electrocardiographic predictors of arrhythmic death and total mortality in the Multicenter Unsustained Tachycardia Trial. Circulation 2004; 110:766-9.
40. Buxton AE, Sweeney MO, Wathen MS, et al., PainFREE Rx Ⅱ Investigators. QRS duration does not predict occurrence of ventricular tachyarrhythmias in patients with implanted cardioverter-defibrillators. J Am Coll Cardiol 2005;46:310-6.
41. Singh JP, Hall WJ, McNitt S, et al., MADIT-Ⅱ Investigators. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation: findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol 2005; 46:1712-20.
42. Hofmann T, Meinertz T, Kasper W, et al. Mode of death in idiopathic dilated cardiomyopathy:a multivariate analysis of prognostic determinants. Am Heart J 1988;116:1455-63.
43. Romeo F, Pelliccia F, Cianfrocca C, Cristofani R, Reale A. Predictors of sudden death in idiopathic dilated cardiomyopathy. Am J Cardiol 1989; 63:138-40.
44. Vaidean GD, Schroeder EB, Whitsel EA, et al. Short-term repeatability of electrocardiographic spatial T-wave axis and QT interval. J Electrocardiol 2005;38:139-47.
45. Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction:results from a cohort of 2265 patients with an ejection fraction of_ or _40%. Am Heart J 2003;145:132-8.
46. Gang Y, Ono T, Hnatkova K, et al., ELITE Ⅱ Investigators. QT dispersion has no prognostic value in patients with symptomatic heart failure:an ELITE Ⅱ substudy. Pacing Clin Electrophysiol 2003;26:394-400.
47. Brendorp B, Elming H, Jun L, et al., Diamond Study Group. QTc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide. Circulation 2001; 103:1422-7.
48. Elming H, Holm E, Jun L, et al. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19:1391-400.
49. Dekker JM, Crow RS, Hannan PJ, Schouten EG, Folsom AR, ARIC Study. Heart rate-corrected QT interval prolongation predicts risk of coronary heart disease in black and while middle-aged men and women:the ARIC study. J Am Coll Cardiol 2004;43:565-71.
50. Davey P. QT interval and mortality from coronary artery disease. Prog Cardiovasc Dis 2000;42:359-84.
51. Pinsky DJ, Sciacca RR, Steinberg JS. QT dispersion as a marker of risk in patients awaiting heart transplantation. J Am Coll Cardiol 1997;29:1576-84.
52. Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol 2000;36:1749-66.
53. Sakabe K, Ikeda T, Sakata T, et al. Comparison of T-wave alternans and QT interval dispersion to predict ventricular tachyarrhythmia in patients with dilated cardiomyopathy and without antiarrhythmic drugs:a prospective study. Jpn Heart J 2001;42:451-7.
54. Brendorp B, Elming H, Jun L, K(?)ber L, Torp-Pedersen C, DIAMOND Study Group. Danish Investigations Of Arrhythmia and Mortality On Dofetilide. Effect of dofetilide on QT dispersion and the prognostic implications of changes in QT dispersion for patients with congestive heart failure. Eur J Heart Fail 2002;4:201-6.
55. Brendorp B, Elming H, Jun L, et al. QT dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function. Circulation 2001; 103:831-5.
56. Chevalier P, Burri H, Adeleine P, et al., Groupe d'Etude du Pronostic de l'Infarctus du Myocarde. QT dynamicity and sudden death after myocardial infarction: results of a long-term follow-up study. J Cardiovasc Electrophysiol 2003;14:227-33.
57. Hintze U, Vach W, Burchardt H, Videbaek J, M(?)ller M, DIAMOND Study Group. QT interval dynamics predict mortality in high-risk patients after myocardial infarction. Scand Cardiovasc J 2002;36:276-81.
58. Bonnemeier H, Hartmann F, Wiegand UK, Bode F, Katus HA, Richardt G. Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction. J Am Coll Cardiol 2001;37:44-50.
59. Haigney MC, Zareba W, Gentlesk PJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ investigators. QT interval variability and spontaneous ventricular tachycardia or fibrillation in the Multicenter Automatic Defibrillator Implantation Trial (MADIT) Ⅱ patients. J Am Coll Cardiol 2004;44:1481-7.
60. Berger RD, Kasper EK, Baughman KL, Marban E, Calkins H, Tomaselli GF. Beat-to-beat QT interval variability:novel evidence for repolarization in lability in ischemic and nonischemic dilated cardiomyopathy. Circulation 1997;96:1557-65.
61. Batchvarov VN. Ghuran A, Smetana P, et al. QT-RR relationship in healthy subjects exhibits substantial intersubject variability and high intrasubject stability. Am J Physiol Heart Circ Physiol 2002;282:H2356-63.
62. Gardner PI, Ursell PC, Fenoglio JJ Jr., Wit AL. Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. Circulation 1985;72:596-611.
63. Simson MB, Untereker WJ, Spielman SR, et al. Relation between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia. Am J Cardiol 1983; 51:105-12. 64. el-Sherif N, Gough WB, Restivo M, Craelius W, Henkin R, Caref EB. Electrophysiological basis of ventricular late potentials. Pacing Clin Electrophysiol 1990; 13:2140-7.
65. Wiener I, Mindich B, Pitchon R. Fragmented endocardial electrical activity in patients with ventricular tachycardia:a new guide to surgical therapy. Am Heart J 1984; 107:86-90.
66. Cassidy DM, Vassallo JA, Buxton AE, Doherty JU, Marchlinski FE, Josephson ME. The value of catheter mapping during sinus rhythm to localize site of origin of ventricular tachycardia. Circulation 1984;69:1103-10.
67. Manolis AS, Chiladakis JA, Malakos JS, Vassilikos V, Maounis T, Cokkinos DV. Abnormal signal-averaged electrocardiograms in patients with incomplete right bundle-branch block. Clin Cardiol 1997;20:17-22.
68. Okin PM, Stein KM, Lippman N, Lerman BB, Kligfield P. Performance of the signal-averaged electrocardiogram:relation to baseline QRS duration. Am Heart J 1995; 129:932-40.
69. Gatzoulis KA, Carlson MD, Biblo LA, et al. Time domain analysis of the signal averaged electrocardiogram in patients with a conduction defect or a bundle branch block. Eur Heart J 1995; 16:1912-9.
70. Savard P, Rouleau JL, Ferguson J, et al. Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 1997;96:202-13.
71. Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001;24:789-95.
72. Reinhardt L, Makijarvi M, Fetsch T, et al. Noninvasive risk modeling after myocardial infarction. Am J Cardiol 1996;78:627-32.
73. Marques-Vidal P, Ruidavets JB, Prouteau N, Casteignau G, Delay M, Ferrieres J. Prevalence of late potentials in a sample of 487 healthy, middle-aged men from southwestern France. Pacing Clin Electrophysiol 2000;23:888-90.
74. el-Sherif N, Denes P, Katz R, et al., The Cardiac Arrhythmia Suppression Trial/Signal-Averaged Electrocardiogram (CAST/SAECG) Substudy Investigators. Definition of the best prediction criteria of the time domain signal-averaged electrocardiogram for serious arrhythmic events in the postinfarction period. J Am Coll Cardiol 1995;25:908-14.
75. Engel TR, Pierce DL, Murphy SP. Variation in late potentials and the reproducibility of their measurement. Prog Cardiovasc Dis 1993;35:247-62.
76. Goldberger JJ, Challapalli S, Waligora M, et al. Uncertainty principle of signal-averaged electrocardiography. Circulation 2000; 101:2909-15.
77. Pogwizd SM, Hoyt RH, Saffitz JE, Corr PB, Cox JL, Cain ME. Reentrant and focal mechanisms underlying ventricular tachycardia in the human heart. Circulation 1992;86:1872-87.
78. Hood MA, Pogwizd SM, Peirick J, Cain ME. Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs. Circulation 1992;86:1888-901.
79. Reinhardt L, Makijarvi M, Fetsch T, et al. Predictive value of wavelet correlation functions of signal-averaged electrocardiogram in patients after anterior versus inferior myocardial infarction. J Am Coll Cardiol 1996;27:53-9.
80. Vazquez R, Caref EB, Torres F, Reina M, Guerrero JA, El-Sherif N. Reproducibility of time-domain and three different frequency-domain techniques for the analysis of the signal-averaged electrocardiogram. J Electrocardiol 2000;33:99-105.
81. Gottfridsson C, Karlsson T, Edvardsson N. The short-term and long-term reproducibility of spectral turbulence and late potential variables of the signal-averaged ECG in a population sample of healthy subjects and the impact of gender, age, and noise. J Electrocardiol 2000;33:107-17.
82. Bloomfield DM, Snyder JE, Steinberg JS. A critical appraisal of quantitative spectro-temporal analysis of the signal-averaged ECG:predicting arrhythmic events after myocardial infarction. Pacing Clin Electrophysiol 1996; 19:768-77.
83. Kavesh NG, Cain ME, Ambos HD, Arthur RM. Enhanced detection of distinguishing features in signal-averaged electrocardiograms from patients with ventricular tachycardia by combined spatial and spectral analyses of entire cardiac cycle. Circulation 1994;90:254-63.
84. Vazquez R, Caref EB, Torres F, Reina M, Ortega F, el-Sherif N. Short-term reproducibility of time domain, spectral temporal mapping, and spectral turbulence analysis of the signal-averaged electrocardiogram in normal subjects and patients with acute myocardial infarction. Am Heart J 1995;130:1011-9.
85. Englund A, Andersson M, Bergfeldt L. Spectral turbulence analysis of the signal-averaged electrocardiogram for predicting inducible sustained monomorphic ventricular tachycardia in patients with and without bundle branch block. Eur Heart J 1995;16:1936-42.
86. Steinbigler P, Haberl R, Bruggemann T, Andresen D, Steinbeck G. Postinfarction risk assessment for sudden cardiac death using late potential analysis of the digital Holter electrocardiogram. J Cardiovasc Electrophysiol 2002;13:1227-32.
87. Ikeda T, Sakata T, Takami M, et al. Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction. A prospective study. J Am Coll Cardiol 2000;35:722-30.
88. Touboul P, Andre-Fouet X, Leizorovicz A, et al., The Groupe d'Etude du Pronostic de l'Infarctus du Myocarde (GREPI). Risk stratification after myocardial infarction. A reappraisal in the era of thrombolysis. Eur Heart J 1997;18:99-107.
89. Kawalsky DL, Garratt KN, Hammill SC, Bailey KR, Gersh BJ. Effect of infarct-related artery patency and late potentials on late mortality after acute myocardial infarction. Mayo Clin Proc 1997;72:414-21.
90. Hartikainen JE, Malik M, Staunton A, Poloniecki J, Camm AJ. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
91. Steinberg JS, Hochman JS, Morgan CD, et al. Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG. Results of a multicenter randomized trial. LATE Ancillary Study Investigators. Late Assessment of Thrombolytic Efficacy. Circulation 1994;90:746-52.
92. Evrengul H, Dursunoglu D, Kayikcioglu M, et al. Effects of a betablocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving successful thrombolytic therapy. Jpn Heart J 2004;45:11-21.
93. Karam C, Golmard J, Steg PG. Decreased prevalence of late potentials with mechanical versus thrombolysis-induced reperfusion in acute myocardial infarction. J Am Coll Cardiol 1996;27:1343-8.
94. Denes P, el-Sherif N, Katz R, et al., Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Am J Cardiol 1994;74:216-20.
95. Hofmann T, Burmeister A, Meinertz T. Prognostic significance of the signal averaged electrocardiogram in patients with chronic stable coronary artery disease: analysis in the time domain and by spectral temporal mapping. Z Kardiol 2004;93:32-42.
96. Gomes JA, Cain ME, Buxton AE, Josephson ME, Lee KL, Hafley GE. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Circulation 2001; 104:436-41.
97. Gold MR, Bloomfield DM, Anderson KP, et al. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 2000;36:2247-53.
98. Bigger JT Jr., Whang W, Rottman JN, et al. Mechanisms of death in the CABG Patch trial:a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. Circulation 1999;99:1416-21.
99. Scharf C, Redecker H, Duru F, et al. Sudden cardiac death after coronary artery bypass grafting is not predicted by signal-averaged ECG. Ann Thorac Surg 2001;72:1546-51.
100. Turitto Turitto G, Ahuja RK, Bekheit S, Caref EB, Ibrahim B, el-Sherif N. Incidence and prediction of induced ventricular tachyarrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 1994;73:770-3.
101. Turitto G, Ahuja RK, Caref EB, el-Sherif N. Risk stratification for arrhythmic events in patients with nonischemic dilated cardiomyopathy and nonsustained ventricular tachycardia:role of programmed ventricular stimulation and the signal-averaged electrocardiogram. J Am Coll Cardiol 1994;24:1523-8.
102. Kondo N. Ikeda T, Kawase A, et al. Clinical usefulness of the combination of T-wave alternans and late potentials for identifying high-risk patients with moderately or severely impaired left ventricular function. Jpn Circ J 2001;65:649-53.
103. Fauchier L, Babuty D, Cosnay P, Poret P, Rouesnel P, Fauchier JP. Long-term prognostic value of time domain analysis of signal-averaged electrocardiography in idiopathic dilated cardiomyopathy. Am J Cardiol 2000;85:618-23.
104. Goedel-Meinen L, Hofmann M, Ryba S, Schomig A. Prognostic value of an abnormal signal-averaged electrocardiogram in patients with nonischemic dilated cardiomyopathy. Am J Cardiol 2001;87:809-12.
105. Hohnloser SH, Klingenheben T, Bloomfield D, Dabbous O, Cohen RJ. Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy:results from a prospective observational study. J Am Coll Cardiol 2003;41:2220-4.
106. Grimm W, Glaveris C, Hoffmann J, et al. Arrhythmia risk stratification in idiopathic dilated cardiomyopathy based on echocardiography and 12-lead, signal-averaged, and 24-hour Holter electrocardiography. Am Heart J 2000; 140:43-51.
107. Brembilla-Perrot B, Terrier de la Chaise A, Jacquemin L, Beurrier D, Houplon P. The signal-averaged electrocardiogram is of limited value in patients with bundle branch block and dilated cardiomyopathy in predicting inducible ventricular tachycardia or death. Am J Cardiol 1997; 79:154-9.
108. Galinier M, Albenque JP, Afchar N, et al. Prognostic value of late potentials in patients with congestive heart failure. Eur Heart J 1996; 17:264-71.
109. Silverman ME, Pressel MD, Brackett JC, Lauria SS, Gold MR, Gottlieb SS. Prognostic value of the signal-averaged electrocardiogram and a prolonged QRS in ischemic and nonischemic cardiomyopathy. Am J Cardiol 1995;75:460-4.
110. Yi G, Keeling PJ, Goldman JH, Hnatkova K, Malik M, McKenna WJ. Comparison of time domain and spectral turbulence analysis of the signal-averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy. Clin Cardiol 1996; 19:800-8.
111. Yi G, Keeling PJ, Goldman JH, Jian H, Poloniecki J, McKenna WJ. Prognostic significance of spectral turbulence analysis of the signalaveraged electrocardiogram in patients with idiopathic dilated cardiomyopathy. Am J Cardiol 1995;75:494-7.
112. Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999;34:912-48.
113. Kotler MN, Tabatznik B, Mower MM, Tominaga S. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation 1973;47:959-66.
114. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy:prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985;55:146-51.
115. Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991;68:887-96.
116. Tavazzi L, Volpi A. Remarks about postinfarction prognosis in light of the experience with the Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI) trials. Circulation 1997;95:1341-5.
117. Hohnloser SH, Franck P, Klingenheben T, Zabel M, Just H. Open infarct artery, late potentials, and other prognostic factors in patients after acute myocardial infarction in the thrombolytic era. A prospective trial. Circulation 1994;90:1747-56.
118. Cairns JA, Connolly SJ, Roberts R, Gent M, Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations:CAMIAT. Lancet 1997;349:675-82.
119. Maggioni AP, Zuanetti G, Franzosi MG, et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993;87:312-22.
120. Julian DG, Camm AJ, Frangin G, et al., European Myocardial Infarct Amiodarone Trial Investigators. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction:EMIAT. Lancet 1997;349:667-74.
121. Kron J, Hart M, Schual-Berke S, Niles NR, Hosenpud JD, McAnulty JH. Idiopathic dilated cardiomyopathy. Role of programmed electrical stimulation and Holter monitoring in predicting those at risk of sudden death. Chest 1988;93:85-90.
122. Huang SK, Messer JV, Denes P. Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy:observations in 35 patients. Am J Cardiol 1983;51:507-12.
123. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, Curiel R, Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA). Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994;344:493-8.
124. Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996;94:3198-203.
125. Ikegawa T, Chino M, Hasegawa H, et al. Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study. Clin Cardiol 1987; 10:78-82.
126. Pelliccia F, Gallo P, Cianfrocca C, d'Amati G, Bernucci P, Reale A. Relation of complex ventricular arrhythmias to presenting features and prognosis in dilated cardiomyopathy. Int J Cardiol 1990;29:47-54.
127. Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984;54:147-52.
128. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. The preliminary report:effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406-12.
129. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G, Multicenter Unsustained Tachycardia Trial Investigators. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 1999;341:1882-90.
130. Kleiger RE, Miller JP, Bigger JT Jr., Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987;59:256-62.
131. Forslund L, Bjorkander I, Ericson M, et al. Prognostic implications of autonomic function assessed by analyses of catecholamines and heart rate variability in stable angina pectoris. Heart 2002;87:415-22.
132. Gerritsen J, Dekker JM, TenVoorde BJ, et al. Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease:the Hoorn Study. Diabetes Care 2001;24:1793-8.
133. La Rovere MT, Bigger JT Jr., Marcus FI, Mortara A, Schwartz PJ, ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet 1998;351:478-84.
134. Camm AJ, Pratt CM, Schwartz PJ, et al., AzimiLide post Infarct surVival Evaluation (ALIVE) Investigators. Mortality in patients after a recent myocardial infarction:a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification. Circulation 2004; 109:990-6.
135. Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-30.
136. Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003;67:601-4.
137. 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;353:1390-6.
138. Ghuran A, Reid F, La Rovere MT, et al., ATRAMI Investigators. Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (The Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol 2002;89:184-90.
139. Bonnemeier H, Wiegand UK, Friedlbinder J, et al. Reflex cardiac activity in ischemia and reperfusion:heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Circulation 2003;108:958-64.
140. Davies LC, Francis DP, Ponikowski P, Piepoli MF, Coats AJ. Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure. Am J Cardiol 2001;87:737-42.
141. Koyama J, Watanabe J, Yamada A, et al. Evaluation of heart-rate turbulence as a new prognostic marker in patients with chronic heart failure. Circ J 2002;66:902-7.
142. Grimm W, Schmidt G. Maisch B, Sharkova J, Muller HH, Christ M. Prognostic significance of heart rate turbulence following ventricular premature beats in patients with idiopathic dilated cardiomyopathy. J Cardiovasc Electrophysiol 2003;14:819-24.
143. Rosenbaum DS, Jackson LE, Smith JM, Garan H, Ruskin JN, Cohen RJ. Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med 1994;330:235-41.
144. Walker ML, Rosenbaum DS. Repolarization alternans:implications for the mechanism and prevention of sudden cardiac death. Cardiovasc Res 2003;57:599-614.
145. Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation 1999;99:1385-94.
146. Bloomfield DM, Ritvo BS, Parides MK, Kim MH. The immediate reproducibility of T wave alternans during bicycle exercise. Pacing Clin Electrophysiol 2002;25:1185-91.
147. Turitto G, Mirandi AP, Pedalino RP, Uretsky S, El-Sherif N. Short-term reproducibility of T wave alternans measurement. J Cardiovasc Electrophysiol 2002;13:641-4.
148. Klingenheben T, Zabel M, D'Agostino RB, Cohen RJ, Hohnloser SH. Predictive value of T-wave alternans for arrhythmic events in patients with congestive hear failure. Lancet 2000;356:651-2.
149. Rashba EJ, Osman AF, MacMurdy K, et al. Enhanced detection of arrhythmia vulnerability using T wave alternans, left ventricular ejection fraction, and programmed ventricular stimulation:a prospective study in subjects with chronic ischemic heart disease. J Cardiovasc Electrophysiol 2004; 15:170-6.
150. Tanno K, Ryu S, Watanabe N, et al. Microvolt T-wave alternans as a predictor of ventricular tachyarrhythmias:a prospective study using atrial pacing. Circulation 2004; 109:1854-8.
151. Rashba EJ, Osman AF, MacMurdy K, et al. Exercise is superior to pacing for T wave alternans measurement in subjects with chronic coronary artery disease and left ventricular dysfunction. J Cardiovasc Electrophysiol 2002; 13:845-50.
152. Lauer MS, Topol EJ. Clinical trials:multiple treatments, multiple end points, and multiple lessons. JAMA 2003;289:2575-7.
153. Bloomfield DM, Steinman RC, Namerow PB, et al. Microvolt T-wave alternans distinguishes between patients likely and patients not likely to benefit from implanted cardiac defibrillator therapy:a solution to the Multicenter Automatic Defibrillator Implantation Trial (MADIT) Ⅱ conundrum. Circulation 2004; 110:1885-9.
154. Bloomfield DM, Bigger JT, Steinman RC, et al. Microvolt T-wave alternans and the risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction. J Am Coll Cardiol 2006;47:456-63.
155. Chow T, Kereiakes DJ, Bartone C, et al. Prognostic utility of microvolt T-wave alternans in risk stratification of patients with ischemic cardiomyopathy. J Am Coll Cardiol 2006;47:1820-7.
156. Gehi AK, Stein RH, Metz LD, Gomes JA. Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events:a metaanalysis. J Am Coll Cardiol 2005;46:75-82.
[2]Bayes de luna A, Coumel P, Leclerq JF, Ambulatory sudden cardiac death:mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J.1989;117:115-159.
[3]Rouleau JL, Talajic M, Sussex B, et al. Myocardial infarction patients in the 1990s--their risk factors, stratification and survival in Canada:the Canadian Assessment of Myocardial Infarction (CAMI) Study. J Am Coll Cardiol.1996 Apr; 27(5):1119-1127
[4]Podrid PJ, Myerburg RJ. Epidemiology and stratification of risk for sudden cardiac death. Clin Cardiol.2005; 28(11 Suppl 1):3-11.
[5]Bigger JT Jr, Fleiss JL, Kleiger R, et al. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction.Circulation 1984; 69:250-258
[6]Richards DA, Byth K, Ross DL, et al. What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction? Circulation. 1991;83(3):756-763.
[7]Steinberg JS, Regan A, Sciacca RR, et al. Predicting arrhythmic events after acute myocardial infarction using the signal-averaged electrocardiogram. Am J Cardiol. 1992; 69(1):13-21.
[8]Windhagen-Mahnert B, Kadish AH. Application of noninvasive and invasive tests for risk assessment in patients with ventricular arrhythmias. Cardiol Clin.2000; 18(2):243-263.
[9]Bailey JJ, Berson AS, Handelsman H, et al. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol.2001; 38(7):1902-1911.
[10]Shamim W, Francis DP, Yousufuddin M, et al. Intraventricular conduction delay:a prognostic marker in chronic heart failure. Int J Cardiol 1999; 70:171-178.
[11]Buxton AE, Sweeney MO, Wathen MS, et al., PainFREE Rx Ⅱ Investigators. QRS duration does not predict occurrence of ventricular tachyarrhythmias in patients with implanted cardioverter-defibrillators. J Am Coll Cardiol 2005; 46:310-316.
[12]Singh JP, Hall WJ, McNitt S, et al., MADIT-Ⅱ Investigators. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation: findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol 2005; 46:1712-1720.
[13]Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction:results from a cohort of 2265 patients with an ejection fraction of_ or _40%. Am Heart J 2003; 145:132-8.
[14]Gang Y, Ono T, Hnatkova K, et al., ELITE Ⅱ Investigators. QT dispersion has no prognostic value in patients with symptomatic heart failure:an ELITE Ⅱ substudy. Pacing Clin Electrophysiol 2003;26:394-400.
[15]Brendorp B, Elming H, Jun L, et al., Diamond Study Group. QTc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide. Circulation 2001; 103:1422-7.
[16]Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999;34:912-48.
[17]Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991;68:887-96.
[18]Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996;94:3198-203.
[19]Camm AJ, Pratt CM, Schwartz PJ, et al., AzimiLide post Infarct surVival Evaluation (ALIVE) Investigators. Mortality in patients after a recent myocardial infarction:a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification. Circulation 2004; 109:990-6.
[20]Hohnloser SH, Kuck KH, Dorian P, et al., DINAMIT Investigators. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med.2004; 351:2481-8.
[21]Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-30.
[22]Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003; 67: 601-4.
[23]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;353:1390-6.
[24]Pham Q, Quan KJ, Rosenbaum DS. T-wave alternans:marker, mechanism, and methodology for predicting sudden cardiac death. J Electrocardiol.2003;36:75-81.
[25]Estes NA 3rd, Michaud G, Zipes DP, et al. Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias. Am J Cardiol.1997; 80(10):1314-8.
[26]Goldberger, Cain, Hohnloser, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. J Am Coll Cardiol,2008; 52: 1179-1199.
[27]Myerburg RJ, Mitrani R, Interian A Jr., Castellanos A. Interpretation of outcomes of antiarrhythmic clinical trials:design features and population impact. Circulation 1998; 97:1514-1521.
[28]Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV:the ST segment, T and U waves, and the QT interval:a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol,2009,53:982-991.
[29]. Cain ME, Anderson JL, Ansdorf MF, et al. ACC Expert Consensus Document: signal-averaged electrocardiography. J Am Coll Cardiol,1996; 27:238-249.
[30]Nearing BD, Oesterle SN, Verrier RL. Quantification of ischaemia induced vulnerability by precordial T wave alternans analysis in dog and human. Cardiovascular Res 1994;28:1440.
[31]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;353:1390-1396.
[32]Barthel P, Schneider R, Bauer A et al. Risk stratification after acute myocardial infarction by heart rate turbulence. Circulation,2003;108:1221-1226.
[33]Tapanainen JM, Still A-M, Airaksinen KEJ et al. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction: results of a prospective follow-up study. J Cardiovasc Electrophysiol,2001; 12: 645-652.
[34]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. Circulation,2001; 103:2072-2077
[35]The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983;309:331.
[36]Moss AJ, Hall WJ, Cannom DS. Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996;335:1933.
[37]Bardy GH, Lee KL, Mark DB. Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225.
[38]Kadish A, Dyer A, Daubert JP. Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151.
[39]Singh JP, Hall WJ, McNitt S, et al. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation:findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol,2005,46:1712-1720.
[40]Kashani A, Barold SS. Significance of QRS complex duration in patients with heart failure. J Am Coll Cardiol,2005,46:2183-2192.
[41]Goldberger JJ, Cain ME, Hohnloser SH, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. J Am Coll Cardiol, 2008,52:1179-1199.
[42]Tabrizi F, Englund A, Rosenqvist M, et al. Influence of left bundle branch block on long-term mortality in a population with heart failure. Eur Heart J,2007,28: 2449-2455.
[43]Barsheshet A, Goldenberg I, Garty M, et al. Relation of bundle branch block to long-term (four-year) mortality in hospitalized patients with systolic heart failure. Am J Cardiol,2011,107:540-544.
[44]Dekker JM, Crow RS, Hannan PJ, et al. Heart rate-corrected QT interval prolongation predicts risk of coronary heart disease in black and white middle-aged men and women:the ARIC study. J Am Coll Cardiol,2004,43:565-571.
[45]Davey P. QT interval and mortality from coronary artery disease. Prog Cardiovasc Dis,2000,42:359-384.
[46]Selker HP, Raitt MH, Schmid CH, et al. Time-dependent predictors of primary cardiac arrest in patients with acute myocardial infarction. Am J Cardiol,2003,91: 280-286.
[47]Kabakci G, Onalan O, Batur MK, et al. What is the optimal evaluation time of the QT dispersion after acute myocardial infarction for the risk stratification? Angiology, 2001,52:463-468.
[48]Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV:the ST segment, T and U waves, and the QT interval:a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol,2009,53:982-991
[49]Kuchar DL, Thorburn CW, Sammel NL. Late potentials detected after myocardial infarction:natural history and prognostic significance. Circulation. 1986;74:1280-1289.
[50]Hartikainen JEK, Malik M, Staunton A, et al. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
[51]Pogwizd SM, Hoyt RH, Saffitz JE, Corr PB, Cox JL, Cain ME. Reentrant and focal mechanisms underlying ventricular tachycardia in the human heart. Circulation 1992;86:1872-87.
[52]Hood MA, Pogwizd SM, Peirick J, Cain ME. Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs. Circulation 1992;86:1888-901.
[53]Reinhardt L, Makijarvi M, Fetsch T, et al. Predictive value of wavelet correlation functions of signal-averaged electrocardiogram in patients after anterior versus inferior myocardial infarction. J Am Coll Cardiol 1996;27:53-9.
[54]Vazquez R, Caref EB, Torres F, Reina M, Guerrero JA, El-Sherif N. Reproducibility of time-domain and three different frequency-domain techniques for the analysis of the signal-averaged electrocardiogram. J Electrocardiol 2000;33:99-105.
[55]Gottfridsson C, Karlsson T, Edvardsson N. The short-term and long-term reproducibility of spectral turbulence and late potential variables of the signal-averaged ECG in a population sample of healthy subjects and the impact of gender, age, and noise. J Electrocardiol 2000;33:107-17.
[56]Bloomfield DM, Snyder JE, Steinberg JS. A critical appraisal of quantitative spectro-temporal analysis of the signal-averaged ECG:predicting arrhythmic events after myocardial infarction. Pacing Clin Electrophysiol 1996; 19:768-77.
[57]Kavesh NG, Cain ME, Ambos HD, Arthur RM. Enhanced detection of distinguishing features in signal-averaged electrocardiograms from patients with ventricular tachycardia by combined spatial and spectral analyses of entire cardiac cycle. Circulation 1994;90:254-63.
[58]Vazquez R, Caref EB, Torres F, Reina M, Ortega F, el-Sherif N. Short-term reproducibility of time domain, spectral temporal mapping, and spectral turbulence analysis of the signal-averaged electrocardiogram in normal subjects and patients with acute myocardial infarction. Am Heart J 1995;130:1011-9.
[59]Englund A, Andersson M, Bergfeldt L. Spectral turbulence analysis of the signal-averaged electrocardiogram for predicting inducible sustained monomorphic ventricular tachycardia in patients with and without bundle branch block. Eur Heart J 1995;16:1936-42.
[60]Huikuri HV, Tapanainen JM, Lindgren K, et al. Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era. J Am Coll Cardiol 2003; 42:652-8.
[61]Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001; 24:789-95.
[62]Steinbigler P, Haberl R, Bruggemann T, Andresen D, Steinbeck G. Postinfarction risk assessment for sudden cardiac death using late potential analysis of the digital Holter electrocardiogram. J Cardiovasc Electrophysiol 2002; 13:1227-32.
[63]Ikeda T, Sakata T, Takami M, et al. Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction. A prospective study. J Am Coll Cardiol 2000; 35:722-30.
[64]Touboul P, Andre-Fouet X, Leizorovicz A, et al., The Groupe d'Etude du Pronostic de 1'Infarctus du Myocarde (GREPI). Risk stratification after myocardial infarction. A reappraisal in the era of thrombolysis. Eur Heart J 1997; 18:99-107.
[65]Kawalsky DL, Garratt KN, Hammill SC, Bailey KR, Gersh BJ. Effect of infarct-related artery patency and late potentials on late mortality after acute myocardial infarction. Mayo Clin Proc 1997; 72:414-21.
[66]Hartikainen JE, Malik M, Staunton A, Poloniecki J, Camm AJ. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
[67]Steinberg JS, Hochman JS, Morgan CD, et al. Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG. Results of a multicenter randomized trial. LATE Ancillary Study Investigators. Late Assessment of Thrombolytic Efficacy. Circulation 1994; 90:746-52.
[68]Evrengul H, Dursunoglu D, Kayikcioglu M, et al. Effects of a betablocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving successful thrombolytic therapy. Jpn Heart J 2004; 45:11-21.
[69]Karam C, Golmard J, Steg PG. Decreased prevalence of late potentials with mechanical versus thrombolysis-induced reperfusion in acute myocardial infarction. J Am Coll Cardiol 1996; 27:1343-8.
[70]Denes P, el-Sherif N, Katz R, et al., Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Am J Cardiol 1994;74:216-20.
[71]Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001; 38:1902-11.
[72]Savard P, Rouleau JL, Ferguson J, et al. Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 1997;96:202-13.
[73]Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001; 24:789-95.
[74]Hofmann T, Burmeister A, Meinertz T. Prognostic significance of the signal averaged electrocardiogram in patients with chronic stable coronary artery disease: analysis in the time domain and by spectral temporal mapping. Z Kardiol 2004; 93:32-42.
[75]Gomes JA, Cain ME, Buxton AE, Josephson ME, Lee KL, Hafley GE. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Circulation 2001;104:436-41.
[76]Gold MR, Bloomfield DM, Anderson KP, et al. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 2000; 36:2247-53.
[77]Bigger JT Jr., Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. N Engl J Med 1997;337:1569-75.
[78]Bigger JT Jr., Whang W, Rottman JN, et al. Mechanisms of death in the CABG Patch trial:a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. Circulation 1999; 99:1416-21.
[79]Scharf C, Redecker H, Duru F, et al. Sudden cardiac death after coronary artery bypass grafting is not predicted by signal-averaged ECG. Ann Thorac Surg 2001; 72:1546-51.
[80]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;353:1390-1396.
[81]Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-330.
[82]Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003; 67:601-604.
[83]Reinfrnrdt L, M&ij&vi M, Fetsch T, Martirrez-Rrrbio A, Biicker D, Block M, Borggrefe M, Breithardt G. Reduced beat-to-beat changes of heart rate:an important risk factor after myocardial infarction. Cardiology,1996; 87:104-111.
[84]La Rovere MT, Bigger JT, Marcus FI, et al. Baroreflex sensitivity and heart rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet, 1998; 351:478-484.
[85]El-Sherif N, Denes P, Katz R, et al. Definition of the best prediction criteria of the time-domain signal-averaged electrocardiogram for serious arrhythmic events in the post-infarction period. J Am Coll Cardiol,1995; 25:908-914.
[86]Gomes JA, Winters SL, Martinson M, et al. The prognostic significance of quantitative signal-averaged variables relative to clinical variables, site of myocardial infarction, ejection fraction and ventricular premature beats:a prospective study. J Am Coll Cardiol,1988; 13:377-384.
[87]J. Anthony Gomes, Michael E. Cain, Alfred E. Buxton, Mark E. Josephson, Kerry L. Lee and Gail E. Hafley. Prediction of Long-Term Outcomes by Signal-Averaged Electrocardiography in Patients With Unsustained Ventricular Tachycardia, Coronary Artery Disease, and Left Ventricular Dysfunction. Circulation, 2001; 104:436-441
[88]Copie X, Hnatkova K, Staunton A, et al. Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction:Results of a two-year follow-up study. J Am Coll Cardiol 1996; 27:270-276.
[89]Gomes JA, Winters SL, Stewart D, et al. A new non-invasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction:Based on signal-averaged electrocardiogram, radionuclide ejection fraction, and Holter monitoring. J Am Coll Cardiol 1987; 10:349-357.
[90]Kuchar DL, Thornburn CW, Sammel NL. Prediction of serious arrhythmic events after myocardial infarction:Signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol 1987; 9:531-538.
[91]Barron HV, Viskin S. Autonomic markers and prediction of cardiac death after myocardial infarction. Lancet,1998; 351:461-462.
[92]Cain ME, Anderson JL, Ansdorf MF, et al. ACC Expert Consensus Document: signal-averaged electrocardiography. J Am Coll Cardiol,1996; 27:238-249.
[93]Reinhardt L, Makijarvi M, Fetsch T, et al. Noninvasive risk modeling after myocardial infarction. Am J Cardiol 1996; 78:627-32.
[94]Bonnemeier H, Wiegand UK, Friedlbinder J, Schulenburg S, Hartmann F, Bode F, Katus HA, Richardt G. Reflex cardiac activity in ischemia and reperfusion:heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Circulation,2003; 108:958-964.
[95]Sade E, Aytemir K, Oto A, Nazli N, Ozmen F, Ozkutlu H, Tokgozoglu L, Aksoyek S, Ovunc K, Kabakci G, Ozer N, Kes S. Assessment of heart rate turbulence in the acute phase of myocardial infarction for long-term prognosis. Pacing Clin Electrophysiol.2003; 26:544-50.
[96]Walker ML, Rosenbaum DS. Repolarization alternans:implications for the mechanism and prevention of sudden cardiac death. Cardiovasc Res 2003; 57:599-614.
[97]Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation 1999; 99:1385-94.
[98]Verrier RL, Nearing BD, La Rovere MT, Pinna GD, Mittleman MA, Bigger JT, Schwartz PJ. Ambulatory electrocardiogram-based tracking of T-wave alternans in postmyocardial infarction patients to assess risk of cardiac arrest or arrhythmic death. J Cardiovasc Electrophysiol 2003;14:705.
[99]Stein P, Sanghavi D, Domitrovich P, Mackey RA, Deedwania P. 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 Cardiovasc Electrophysiol 2008; 19:1037.
[100]Stein PK, Sanghavi D, Sotoodehnia N, Siscovick DS, Gottdiener J. Association of Holter-based measures including T-wave alternans with risk of sudden cardiac death in the community-dwelling elderly:the Cardiovascular Health Study. J Electrocardiol 2010;43:251.
[101]Sakaki K, Ikeda T, Miwa Y, Miyakoshi M, Abe A, Tsukada T, Ishiguro H, Mera H, Yusu S, Yoshino H. 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.
[102]Gehi AK, Stein RH, Metz LD, Gomes JA. Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events:a metaanalysis. J Am Coll Cardiol 2005; 46:75-82.
[103]Verrier, Klingenheben, Malik, El-Sherif, Exner, Hohnloser, Ikeda, Narayan, Nieminen, Rosenbaum. Microvolt T-Wave Alternans Physiological Basis, Methods of Measurement, and Clinical Utility—Consensus Guideline by International Society for Holter and Noninvasive Electrocardiology. JACC 2011;58:1309-1324
[104]Nieminen T, Lehtimaki T, Viik J, Lehtinen R, Nikus K, Koobi T, Niemela K, Turjanmaa V, Kaiser W, Huhtala H, Verrier RL, Huikuri H, Kahonen M. T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. Eur Heart J 2007; 28:2332.
[105]Exner DV, Kavanagh KM, Slawnych MP, Mitchell LB, Ramadan D, Aggarwal SG, Noullett C, Schaik AV, Mitchell RT, Shibata MA, Gulamhussein S, McMeekin J, Tymchak W, Schnell G, Gillis AM, Sheldon RS, Fick GH, Duff HJI. Noninvasive risk assessment early after a myocardial infarction:The REFINE Study. J Am Coll Cardiol 2007; 50:2275.
[106]Tapanainen JM, Still AM, Airaksinen KE, Huikuri HV. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction:Results of a prospective follow-up study. J Cardiovasc Electrophysiol 2001; 12:645.
[107]Solomon SD, Zelenkofske S, McMurray JJ, Finn PV, Velazquez E, Ertl G Harsanyi A, Rouleau JL, Maggioni A, Kober L, White H, Werf FV, Pieper K,Califf RM, Pfeffer MA. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both, N Engl J Med 2005;352:2581.
[108]Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999; 34:912-48.
[109]Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69:250-8.
[110]The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983; 309:331-6.
[111]Kotler MN, Tabatznik B, Mower MM, Tominaga S. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation 1973; 47:959-66.
[112]Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy:prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985;55:146-51.
[113]Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991; 68:887-96.
[114]Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996; 94:3198-203.
[115]McClements BM, Adgey AA. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute infarction in the thrombolytic era. J Am Coll Cardiol 1993; 21:1419-27.
[116]Hohnloser SH, Franck P, Klingenheben T, Zabel M, Just H. Open infarct artery, late potentials, and other prognostic factors in patients after acute myocardial infarction in the thrombolytic era. A prospective trial. Circulation 1994;90:1747-56.
[117]Cairns JA, Connolly SJ, Roberts R, Gent M, Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations:CAMIAT. Lancet 1997;349:675-82.
[118]Maggioni AP, Zuanetti G, Franzosi MG, et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993; 87:312-22.
[119]Julian DG, Camm AJ, Frangin G, et al., European Myocardial Infarct Amiodarone Trial Investigators. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction:EMIAT. Lancet 1997; 349:667-74.
[120]Kron J, Hart M, Schual-Berke S, Niles NR, Hosenpud JD, McAnulty JH. Idiopathic dilated cardiomyopathy. Role of programmed electrical stimulation and Holter monitoring in predicting those at risk of sudden death. Chest 1988; 93:85-90.
[121]Huang SK, Messer JV, Denes P. Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy:observations in 35 patients. Am J Cardiol 1983;51:507-12.
[122]Ikegawa T, Chino M, Hasegawa H, et al. Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study. Clin Cardiol 1987;10:78-82.
[123]Pelliccia F, Gallo P, Cianfrocca C, d'Amati G, Bernucci P, Reale A. Relation of complex ventricular arrhythmias to presenting features and prognosis in dilated cardiomyopathy. Int J Cardiol 1990; 29:47-54.
[124]Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984; 54:147-52.
[125]The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. The preliminary report:effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989; 321:406-12.
[126]Ikeda T, Saito H, Tanno K, Shimizu H, Watanabe J, Ohnishi Y, Kasamaki Y, Ozawa Y.T-wave alternans as a predictor for sudden cardiac death after myocardial infarction. Am J Cardiol.2002; 89(1):79-82.
[127]Kuchar DL, Thorburn CW, Sammel NL.Prediction of serious arrhythmic events after myocardial infarction:signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol,1987; 9(3):531-538
[128]Perkiomaki JS, Hamekoski S, Junttila MJ, Jokinen V, Tapanainen J, Huikuri HV. Predictors of long-term risk for heart failure hospitalization after acute myocardial infarction.Ann Noninvasive Electrocardiol.2010; 15(3):250-8.
1. Pratt CM, Greenway PS, Schoenfeld MH, Hibben ML, Reiffel JA. Exploration of the precision of classifying sudden cardiac death:implications for the interpretation of clinical trials. Circulation 1996;93:519-524.
2. Goldberger JJ, Weinberg KM, Kadish AH. Impact of nontraditional antiarrhythmic drugs on sudden cardiac death. In:Zipes D, Jalife J, editors. Cardiac Electrophysiology:From Cell to Bedside.4th ed. Philadelphia, PA:WB Saunders, 2004:950-958.
3. Myerburg RJ, Mitrani R, Interian A Jr., Castellanos A. Interpretation of outcomes of antiarrhythmic clinical trials:design features and population impact. Circulation 1998;97:1514-1521.
4. Heller RF, Chinn S, Pedoe HD, Rose G. How well can we predict coronary heart disease? Findings in the United Kingdom Heart Disease Prevention Project. Br Med J (Clin Res Ed) 1984;288:1409-11.
5. Rose GA. The Strategy of Preventive Medicine. Oxford, UK:Oxford University Press,1992.
6. Wackers FJ, Berger HJ, Johnstone DE, et al. Multiple gated cardiac blood pool imaging for left ventricular ejection fraction:validation of the technique and assessment of variability. Am J Cardiol 1979;43:1159-66.
7. McGowan JH, Cleland JG. Reliability of reporting left ventricular systolic function by echocardiography:a systematic review of 3 methods. Am Heart J 2003;146:388-97.
8. Bigger JT Jr., Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984;69:250-8.
9. Sanz G, Castaner A. Betriu A, et al. Determinants of prognosis in survivors of myocardial infarction:a prospective clinical angiographic study. N Engl J Med 1982;306:1065-70.
10. The Multicenter Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983;309:331-6.
11. Volpi A, De Vita C, Franzosi MG, et al. Determinants of 6-month mortality in survivors of myocardial infarction after thrombolysis:results of the GISSI-2 data base: the Ad hoc Working Group of the Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI)-2 Data Base. Circulation 1993;88:416-29.
12. Huikuri HV, Tapanainen JM, Lindgren K, et al. Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era. J Am Coll Cardiol 2003;42:652-8.
13. McClements BM, Adgey AA. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute infarction in the thrombolytic era. J Am Coll Cardiol 1993;21:1419-27.
14. Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001;38:1902-11.
15. Hohnloser SH, Kuck KH, Dorian P, et al., DINAMIT Investigators. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med 2004;351:2481-8.
16. Solomon SD, Zelenkofske S, McMurray JJ, et al., Valsartan in Acute Myocardial Infarction Trial (VALIANT) Investigators. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med 2005;352:2581-8.
17. Bigger JT Jr., Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. N Engl J Med 1997;337:1569-75.
18. Moss AJ, Hall WJ, Cannom DS, et al. Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996;335:1933-40.
19. Moss AJ,Fadl Y, Zareba W. Cannom DS, Hall WJ, Defibrillator Implantation Trial Research Group. Survival benefit with an implanted defibrillator in relation to mortality risk in chronic coronary heart disease. Am J Cardiol 2001;88:516-20.
20. Buxton AE, Lee KL, Hafley GE, et al., MUSTT Investigators. Relation of ejection fraction and inducible ventricular tachycardia to mode of death in patients with coronary artery disease:an analysis of patients enrolled in the Multicenter Unsustained Tachycardia Trial. Circulation 2002; 106:2466-72.
21. Moss AJ, Zareba W, Hall WJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877-83.
22. Bardy GH, Lee KL, Mark DB, et al., Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225-37.
23. Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med 1994;331:1564-75.
24. Grimm W, Christ M, Bach J, Muller HH, Maisch B. Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy:results of the Marburg cardiomyopathy study. Circulation 2003; 108:2883-91.
25. Kadish A, Dyer A, Daubert JP, et al., Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151-8.
26. Shamim W, Yousufuddin M, Cicoria M, Gibson DG, Coats AJ, Henein MY. Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure. Heart 2002;88:47-51.
27. Desai AD, Yaw TS, Yamazaki T, Kaykha A, Chun S, Froelicher VF. Prognostic significance of quantitative QRS duration. Am J Med 2006; 119:600-6.
28. Nichol G, Kaul P, Huszti E, Bridges JF. Cost-effectiveness of cardiac resynchronization therapy in patients with symptomatic heart failure. Ann Intern Med 2004; 141:343-51.
29. Shamim W, Francis DP, Yousufuddin M, et al. Intraventricular conduction delay:a prognostic marker in chronic heart failure. Int J Cardiol 1999;70:171-8.
30. Park RC, Little WC, O'Rourke RA. Effect of alteration of left ventricular activation sequence on the left ventricular end-systolic pressurevolume relation in closed-chest dogs. Circ Res 1985;57:706-17.
31. Vassallo JA, Cassidy DM, Miller JM, Buxton AE, Marchlinski FE, Josephson ME. Left ventricular endocardial activation during right ventricular pacing:effect of underlying heart disease. J Am Coll Cardiol 1986;7:1228-33.
32. Akar FG, Spragg DD, Tunin RS, Kass DA, Tomaselli GF. Mechanisms underlying conduction slowing and arrhythmogenesis in nonischemic dilated cardiomyopathy. Circ Res 2004;95:717-25.
33. Freedman RA, Alderman EL, Sheffield LT, Saporito M, Fisher LD. Bundle branch block in patients with chronic coronary artery disease:angiographic correlates and prognostic significance. J Am Coll Cardiol 1987; 10:73-80.
34. McCullough PA, Philbin EF, Spertus JA, Kaatz S, Sandberg KR, Weaver WD. Resource Utilization Among Congestive Heart Failure (REACH) Study. Confirmation of a heart failure epidemic:findings from the Resource Utilization Among Congestive Heart Failure (REACH) study. J Am Coll Cardiol 2002;39:60-9.
35. Baldasseroni S, Opasich C, Gorini M, et al., Italian Network on Congestive Heart Failure Investigators. Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: a report from the Italian network on congestive heart failure. Am Heart J 2002;143:398-405.
36. Iuliano S, Fisher SG, Karasik PE, Fletcher RD, Singh SN. Department of Veterans Affairs Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. QRS duration and mortality in patients with congestive heart failure. Am Heart J 2002;143:1085-91.
37. Greenberg H, Case RB, Moss AJ, Brown MW, Carroll ER, Andrews ML, MADIT-Ⅱ Investigators. Analysis of mortality events in the Multicenter Automatic Defibrillator Implantation Trial (MADIT-Ⅱ). J Am Coll Cardiol 2004;43:1459-65.
38. Moss AJ, Zareba W, Hall WJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877-83.
39. Zimetbaum PJ, Buxton AE, Batsford W, et al. Electrocardiographic predictors of arrhythmic death and total mortality in the Multicenter Unsustained Tachycardia Trial. Circulation 2004; 110:766-9.
40. Buxton AE, Sweeney MO, Wathen MS, et al., PainFREE Rx Ⅱ Investigators. QRS duration does not predict occurrence of ventricular tachyarrhythmias in patients with implanted cardioverter-defibrillators. J Am Coll Cardiol 2005;46:310-6.
41. Singh JP, Hall WJ, McNitt S, et al., MADIT-Ⅱ Investigators. Factors influencing appropriate firing of the implanted defibrillator for ventricular tachycardia/fibrillation: findings from the Multicenter Automatic Defibrillator Implantation Trial Ⅱ (MADIT-Ⅱ). J Am Coll Cardiol 2005; 46:1712-20.
42. Hofmann T, Meinertz T, Kasper W, et al. Mode of death in idiopathic dilated cardiomyopathy:a multivariate analysis of prognostic determinants. Am Heart J 1988;116:1455-63.
43. Romeo F, Pelliccia F, Cianfrocca C, Cristofani R, Reale A. Predictors of sudden death in idiopathic dilated cardiomyopathy. Am J Cardiol 1989; 63:138-40.
44. Vaidean GD, Schroeder EB, Whitsel EA, et al. Short-term repeatability of electrocardiographic spatial T-wave axis and QT interval. J Electrocardiol 2005;38:139-47.
45. Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic value of QT interval and QT dispersion in patients with left ventricular systolic dysfunction:results from a cohort of 2265 patients with an ejection fraction of_ or _40%. Am Heart J 2003;145:132-8.
46. Gang Y, Ono T, Hnatkova K, et al., ELITE Ⅱ Investigators. QT dispersion has no prognostic value in patients with symptomatic heart failure:an ELITE Ⅱ substudy. Pacing Clin Electrophysiol 2003;26:394-400.
47. Brendorp B, Elming H, Jun L, et al., Diamond Study Group. QTc interval as a guide to select those patients with congestive heart failure and reduced left ventricular systolic function who will benefit from antiarrhythmic treatment with dofetilide. Circulation 2001; 103:1422-7.
48. Elming H, Holm E, Jun L, et al. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19:1391-400.
49. Dekker JM, Crow RS, Hannan PJ, Schouten EG, Folsom AR, ARIC Study. Heart rate-corrected QT interval prolongation predicts risk of coronary heart disease in black and while middle-aged men and women:the ARIC study. J Am Coll Cardiol 2004;43:565-71.
50. Davey P. QT interval and mortality from coronary artery disease. Prog Cardiovasc Dis 2000;42:359-84.
51. Pinsky DJ, Sciacca RR, Steinberg JS. QT dispersion as a marker of risk in patients awaiting heart transplantation. J Am Coll Cardiol 1997;29:1576-84.
52. Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol 2000;36:1749-66.
53. Sakabe K, Ikeda T, Sakata T, et al. Comparison of T-wave alternans and QT interval dispersion to predict ventricular tachyarrhythmia in patients with dilated cardiomyopathy and without antiarrhythmic drugs:a prospective study. Jpn Heart J 2001;42:451-7.
54. Brendorp B, Elming H, Jun L, K(?)ber L, Torp-Pedersen C, DIAMOND Study Group. Danish Investigations Of Arrhythmia and Mortality On Dofetilide. Effect of dofetilide on QT dispersion and the prognostic implications of changes in QT dispersion for patients with congestive heart failure. Eur J Heart Fail 2002;4:201-6.
55. Brendorp B, Elming H, Jun L, et al. QT dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function. Circulation 2001; 103:831-5.
56. Chevalier P, Burri H, Adeleine P, et al., Groupe d'Etude du Pronostic de l'Infarctus du Myocarde. QT dynamicity and sudden death after myocardial infarction: results of a long-term follow-up study. J Cardiovasc Electrophysiol 2003;14:227-33.
57. Hintze U, Vach W, Burchardt H, Videbaek J, M(?)ller M, DIAMOND Study Group. QT interval dynamics predict mortality in high-risk patients after myocardial infarction. Scand Cardiovasc J 2002;36:276-81.
58. Bonnemeier H, Hartmann F, Wiegand UK, Bode F, Katus HA, Richardt G. Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction. J Am Coll Cardiol 2001;37:44-50.
59. Haigney MC, Zareba W, Gentlesk PJ, et al., Multicenter Automatic Defibrillator Implantation Trial Ⅱ investigators. QT interval variability and spontaneous ventricular tachycardia or fibrillation in the Multicenter Automatic Defibrillator Implantation Trial (MADIT) Ⅱ patients. J Am Coll Cardiol 2004;44:1481-7.
60. Berger RD, Kasper EK, Baughman KL, Marban E, Calkins H, Tomaselli GF. Beat-to-beat QT interval variability:novel evidence for repolarization in lability in ischemic and nonischemic dilated cardiomyopathy. Circulation 1997;96:1557-65.
61. Batchvarov VN. Ghuran A, Smetana P, et al. QT-RR relationship in healthy subjects exhibits substantial intersubject variability and high intrasubject stability. Am J Physiol Heart Circ Physiol 2002;282:H2356-63.
62. Gardner PI, Ursell PC, Fenoglio JJ Jr., Wit AL. Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. Circulation 1985;72:596-611.
63. Simson MB, Untereker WJ, Spielman SR, et al. Relation between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia. Am J Cardiol 1983; 51:105-12. 64. el-Sherif N, Gough WB, Restivo M, Craelius W, Henkin R, Caref EB. Electrophysiological basis of ventricular late potentials. Pacing Clin Electrophysiol 1990; 13:2140-7.
65. Wiener I, Mindich B, Pitchon R. Fragmented endocardial electrical activity in patients with ventricular tachycardia:a new guide to surgical therapy. Am Heart J 1984; 107:86-90.
66. Cassidy DM, Vassallo JA, Buxton AE, Doherty JU, Marchlinski FE, Josephson ME. The value of catheter mapping during sinus rhythm to localize site of origin of ventricular tachycardia. Circulation 1984;69:1103-10.
67. Manolis AS, Chiladakis JA, Malakos JS, Vassilikos V, Maounis T, Cokkinos DV. Abnormal signal-averaged electrocardiograms in patients with incomplete right bundle-branch block. Clin Cardiol 1997;20:17-22.
68. Okin PM, Stein KM, Lippman N, Lerman BB, Kligfield P. Performance of the signal-averaged electrocardiogram:relation to baseline QRS duration. Am Heart J 1995; 129:932-40.
69. Gatzoulis KA, Carlson MD, Biblo LA, et al. Time domain analysis of the signal averaged electrocardiogram in patients with a conduction defect or a bundle branch block. Eur Heart J 1995; 16:1912-9.
70. Savard P, Rouleau JL, Ferguson J, et al. Risk stratification after myocardial infarction using signal-averaged electrocardiographic criteria adjusted for sex, age, and myocardial infarction location. Circulation 1997;96:202-13.
71. Kirchhof P, Eckardt L, Arslan O, et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001;24:789-95.
72. Reinhardt L, Makijarvi M, Fetsch T, et al. Noninvasive risk modeling after myocardial infarction. Am J Cardiol 1996;78:627-32.
73. Marques-Vidal P, Ruidavets JB, Prouteau N, Casteignau G, Delay M, Ferrieres J. Prevalence of late potentials in a sample of 487 healthy, middle-aged men from southwestern France. Pacing Clin Electrophysiol 2000;23:888-90.
74. el-Sherif N, Denes P, Katz R, et al., The Cardiac Arrhythmia Suppression Trial/Signal-Averaged Electrocardiogram (CAST/SAECG) Substudy Investigators. Definition of the best prediction criteria of the time domain signal-averaged electrocardiogram for serious arrhythmic events in the postinfarction period. J Am Coll Cardiol 1995;25:908-14.
75. Engel TR, Pierce DL, Murphy SP. Variation in late potentials and the reproducibility of their measurement. Prog Cardiovasc Dis 1993;35:247-62.
76. Goldberger JJ, Challapalli S, Waligora M, et al. Uncertainty principle of signal-averaged electrocardiography. Circulation 2000; 101:2909-15.
77. Pogwizd SM, Hoyt RH, Saffitz JE, Corr PB, Cox JL, Cain ME. Reentrant and focal mechanisms underlying ventricular tachycardia in the human heart. Circulation 1992;86:1872-87.
78. Hood MA, Pogwizd SM, Peirick J, Cain ME. Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs. Circulation 1992;86:1888-901.
79. Reinhardt L, Makijarvi M, Fetsch T, et al. Predictive value of wavelet correlation functions of signal-averaged electrocardiogram in patients after anterior versus inferior myocardial infarction. J Am Coll Cardiol 1996;27:53-9.
80. Vazquez R, Caref EB, Torres F, Reina M, Guerrero JA, El-Sherif N. Reproducibility of time-domain and three different frequency-domain techniques for the analysis of the signal-averaged electrocardiogram. J Electrocardiol 2000;33:99-105.
81. Gottfridsson C, Karlsson T, Edvardsson N. The short-term and long-term reproducibility of spectral turbulence and late potential variables of the signal-averaged ECG in a population sample of healthy subjects and the impact of gender, age, and noise. J Electrocardiol 2000;33:107-17.
82. Bloomfield DM, Snyder JE, Steinberg JS. A critical appraisal of quantitative spectro-temporal analysis of the signal-averaged ECG:predicting arrhythmic events after myocardial infarction. Pacing Clin Electrophysiol 1996; 19:768-77.
83. Kavesh NG, Cain ME, Ambos HD, Arthur RM. Enhanced detection of distinguishing features in signal-averaged electrocardiograms from patients with ventricular tachycardia by combined spatial and spectral analyses of entire cardiac cycle. Circulation 1994;90:254-63.
84. Vazquez R, Caref EB, Torres F, Reina M, Ortega F, el-Sherif N. Short-term reproducibility of time domain, spectral temporal mapping, and spectral turbulence analysis of the signal-averaged electrocardiogram in normal subjects and patients with acute myocardial infarction. Am Heart J 1995;130:1011-9.
85. Englund A, Andersson M, Bergfeldt L. Spectral turbulence analysis of the signal-averaged electrocardiogram for predicting inducible sustained monomorphic ventricular tachycardia in patients with and without bundle branch block. Eur Heart J 1995;16:1936-42.
86. Steinbigler P, Haberl R, Bruggemann T, Andresen D, Steinbeck G. Postinfarction risk assessment for sudden cardiac death using late potential analysis of the digital Holter electrocardiogram. J Cardiovasc Electrophysiol 2002;13:1227-32.
87. Ikeda T, Sakata T, Takami M, et al. Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction. A prospective study. J Am Coll Cardiol 2000;35:722-30.
88. Touboul P, Andre-Fouet X, Leizorovicz A, et al., The Groupe d'Etude du Pronostic de l'Infarctus du Myocarde (GREPI). Risk stratification after myocardial infarction. A reappraisal in the era of thrombolysis. Eur Heart J 1997;18:99-107.
89. Kawalsky DL, Garratt KN, Hammill SC, Bailey KR, Gersh BJ. Effect of infarct-related artery patency and late potentials on late mortality after acute myocardial infarction. Mayo Clin Proc 1997;72:414-21.
90. Hartikainen JE, Malik M, Staunton A, Poloniecki J, Camm AJ. Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction. J Am Coll Cardiol 1996;28:296-304.
91. Steinberg JS, Hochman JS, Morgan CD, et al. Effects of thrombolytic therapy administered 6 to 24 hours after myocardial infarction on the signal-averaged ECG. Results of a multicenter randomized trial. LATE Ancillary Study Investigators. Late Assessment of Thrombolytic Efficacy. Circulation 1994;90:746-52.
92. Evrengul H, Dursunoglu D, Kayikcioglu M, et al. Effects of a betablocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving successful thrombolytic therapy. Jpn Heart J 2004;45:11-21.
93. Karam C, Golmard J, Steg PG. Decreased prevalence of late potentials with mechanical versus thrombolysis-induced reperfusion in acute myocardial infarction. J Am Coll Cardiol 1996;27:1343-8.
94. Denes P, el-Sherif N, Katz R, et al., Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Am J Cardiol 1994;74:216-20.
95. Hofmann T, Burmeister A, Meinertz T. Prognostic significance of the signal averaged electrocardiogram in patients with chronic stable coronary artery disease: analysis in the time domain and by spectral temporal mapping. Z Kardiol 2004;93:32-42.
96. Gomes JA, Cain ME, Buxton AE, Josephson ME, Lee KL, Hafley GE. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Circulation 2001; 104:436-41.
97. Gold MR, Bloomfield DM, Anderson KP, et al. A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 2000;36:2247-53.
98. Bigger JT Jr., Whang W, Rottman JN, et al. Mechanisms of death in the CABG Patch trial:a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. Circulation 1999;99:1416-21.
99. Scharf C, Redecker H, Duru F, et al. Sudden cardiac death after coronary artery bypass grafting is not predicted by signal-averaged ECG. Ann Thorac Surg 2001;72:1546-51.
100. Turitto Turitto G, Ahuja RK, Bekheit S, Caref EB, Ibrahim B, el-Sherif N. Incidence and prediction of induced ventricular tachyarrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 1994;73:770-3.
101. Turitto G, Ahuja RK, Caref EB, el-Sherif N. Risk stratification for arrhythmic events in patients with nonischemic dilated cardiomyopathy and nonsustained ventricular tachycardia:role of programmed ventricular stimulation and the signal-averaged electrocardiogram. J Am Coll Cardiol 1994;24:1523-8.
102. Kondo N. Ikeda T, Kawase A, et al. Clinical usefulness of the combination of T-wave alternans and late potentials for identifying high-risk patients with moderately or severely impaired left ventricular function. Jpn Circ J 2001;65:649-53.
103. Fauchier L, Babuty D, Cosnay P, Poret P, Rouesnel P, Fauchier JP. Long-term prognostic value of time domain analysis of signal-averaged electrocardiography in idiopathic dilated cardiomyopathy. Am J Cardiol 2000;85:618-23.
104. Goedel-Meinen L, Hofmann M, Ryba S, Schomig A. Prognostic value of an abnormal signal-averaged electrocardiogram in patients with nonischemic dilated cardiomyopathy. Am J Cardiol 2001;87:809-12.
105. Hohnloser SH, Klingenheben T, Bloomfield D, Dabbous O, Cohen RJ. Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy:results from a prospective observational study. J Am Coll Cardiol 2003;41:2220-4.
106. Grimm W, Glaveris C, Hoffmann J, et al. Arrhythmia risk stratification in idiopathic dilated cardiomyopathy based on echocardiography and 12-lead, signal-averaged, and 24-hour Holter electrocardiography. Am Heart J 2000; 140:43-51.
107. Brembilla-Perrot B, Terrier de la Chaise A, Jacquemin L, Beurrier D, Houplon P. The signal-averaged electrocardiogram is of limited value in patients with bundle branch block and dilated cardiomyopathy in predicting inducible ventricular tachycardia or death. Am J Cardiol 1997; 79:154-9.
108. Galinier M, Albenque JP, Afchar N, et al. Prognostic value of late potentials in patients with congestive heart failure. Eur Heart J 1996; 17:264-71.
109. Silverman ME, Pressel MD, Brackett JC, Lauria SS, Gold MR, Gottlieb SS. Prognostic value of the signal-averaged electrocardiogram and a prolonged QRS in ischemic and nonischemic cardiomyopathy. Am J Cardiol 1995;75:460-4.
110. Yi G, Keeling PJ, Goldman JH, Hnatkova K, Malik M, McKenna WJ. Comparison of time domain and spectral turbulence analysis of the signal-averaged electrocardiogram for the prediction of prognosis in idiopathic dilated cardiomyopathy. Clin Cardiol 1996; 19:800-8.
111. Yi G, Keeling PJ, Goldman JH, Jian H, Poloniecki J, McKenna WJ. Prognostic significance of spectral turbulence analysis of the signalaveraged electrocardiogram in patients with idiopathic dilated cardiomyopathy. Am J Cardiol 1995;75:494-7.
112. Crawford MH, Bernstein SJ, Deedwania PC, et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). J Am Coll Cardiol 1999;34:912-48.
113. Kotler MN, Tabatznik B, Mower MM, Tominaga S. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation 1973;47:959-66.
114. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy:prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985;55:146-51.
115. Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM, CAST Investigators. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. Am J Cardiol 1991;68:887-96.
116. Tavazzi L, Volpi A. Remarks about postinfarction prognosis in light of the experience with the Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI) trials. Circulation 1997;95:1341-5.
117. Hohnloser SH, Franck P, Klingenheben T, Zabel M, Just H. Open infarct artery, late potentials, and other prognostic factors in patients after acute myocardial infarction in the thrombolytic era. A prospective trial. Circulation 1994;90:1747-56.
118. Cairns JA, Connolly SJ, Roberts R, Gent M, Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations:CAMIAT. Lancet 1997;349:675-82.
119. Maggioni AP, Zuanetti G, Franzosi MG, et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993;87:312-22.
120. Julian DG, Camm AJ, Frangin G, et al., European Myocardial Infarct Amiodarone Trial Investigators. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction:EMIAT. Lancet 1997;349:667-74.
121. Kron J, Hart M, Schual-Berke S, Niles NR, Hosenpud JD, McAnulty JH. Idiopathic dilated cardiomyopathy. Role of programmed electrical stimulation and Holter monitoring in predicting those at risk of sudden death. Chest 1988;93:85-90.
122. Huang SK, Messer JV, Denes P. Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy:observations in 35 patients. Am J Cardiol 1983;51:507-12.
123. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, Curiel R, Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA). Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994;344:493-8.
124. Doval HC, Nul DR, Grancelli HO, et al., GESICA-GEMA Investigators. Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. Circulation 1996;94:3198-203.
125. Ikegawa T, Chino M, Hasegawa H, et al. Prognostic significance of 24-hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: a prospective study. Clin Cardiol 1987; 10:78-82.
126. Pelliccia F, Gallo P, Cianfrocca C, d'Amati G, Bernucci P, Reale A. Relation of complex ventricular arrhythmias to presenting features and prognosis in dilated cardiomyopathy. Int J Cardiol 1990;29:47-54.
127. Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 1984;54:147-52.
128. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. The preliminary report:effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989;321:406-12.
129. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G, Multicenter Unsustained Tachycardia Trial Investigators. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 1999;341:1882-90.
130. Kleiger RE, Miller JP, Bigger JT Jr., Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987;59:256-62.
131. Forslund L, Bjorkander I, Ericson M, et al. Prognostic implications of autonomic function assessed by analyses of catecholamines and heart rate variability in stable angina pectoris. Heart 2002;87:415-22.
132. Gerritsen J, Dekker JM, TenVoorde BJ, et al. Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease:the Hoorn Study. Diabetes Care 2001;24:1793-8.
133. La Rovere MT, Bigger JT Jr., Marcus FI, Mortara A, Schwartz PJ, ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet 1998;351:478-84.
134. Camm AJ, Pratt CM, Schwartz PJ, et al., AzimiLide post Infarct surVival Evaluation (ALIVE) Investigators. Mortality in patients after a recent myocardial infarction:a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification. Circulation 2004; 109:990-6.
135. Watanabe MA, Marine JE, Sheldon R, Josephson ME. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106:325-30.
136. Kawasaki T, Azuma A, Asada S, et al. Heart rate turbulence and clinical prognosis in hypertrophic cardiomyopathy and myocardial infarction. Circ J 2003;67:601-4.
137. 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;353:1390-6.
138. Ghuran A, Reid F, La Rovere MT, et al., ATRAMI Investigators. Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (The Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol 2002;89:184-90.
139. Bonnemeier H, Wiegand UK, Friedlbinder J, et al. Reflex cardiac activity in ischemia and reperfusion:heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Circulation 2003;108:958-64.
140. Davies LC, Francis DP, Ponikowski P, Piepoli MF, Coats AJ. Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure. Am J Cardiol 2001;87:737-42.
141. Koyama J, Watanabe J, Yamada A, et al. Evaluation of heart-rate turbulence as a new prognostic marker in patients with chronic heart failure. Circ J 2002;66:902-7.
142. Grimm W, Schmidt G. Maisch B, Sharkova J, Muller HH, Christ M. Prognostic significance of heart rate turbulence following ventricular premature beats in patients with idiopathic dilated cardiomyopathy. J Cardiovasc Electrophysiol 2003;14:819-24.
143. Rosenbaum DS, Jackson LE, Smith JM, Garan H, Ruskin JN, Cohen RJ. Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med 1994;330:235-41.
144. Walker ML, Rosenbaum DS. Repolarization alternans:implications for the mechanism and prevention of sudden cardiac death. Cardiovasc Res 2003;57:599-614.
145. Pastore JM, Girouard SD, Laurita KR, Akar FG, Rosenbaum DS. Mechanism linking T-wave alternans to the genesis of cardiac fibrillation. Circulation 1999;99:1385-94.
146. Bloomfield DM, Ritvo BS, Parides MK, Kim MH. The immediate reproducibility of T wave alternans during bicycle exercise. Pacing Clin Electrophysiol 2002;25:1185-91.
147. Turitto G, Mirandi AP, Pedalino RP, Uretsky S, El-Sherif N. Short-term reproducibility of T wave alternans measurement. J Cardiovasc Electrophysiol 2002;13:641-4.
148. Klingenheben T, Zabel M, D'Agostino RB, Cohen RJ, Hohnloser SH. Predictive value of T-wave alternans for arrhythmic events in patients with congestive hear failure. Lancet 2000;356:651-2.
149. Rashba EJ, Osman AF, MacMurdy K, et al. Enhanced detection of arrhythmia vulnerability using T wave alternans, left ventricular ejection fraction, and programmed ventricular stimulation:a prospective study in subjects with chronic ischemic heart disease. J Cardiovasc Electrophysiol 2004; 15:170-6.
150. Tanno K, Ryu S, Watanabe N, et al. Microvolt T-wave alternans as a predictor of ventricular tachyarrhythmias:a prospective study using atrial pacing. Circulation 2004; 109:1854-8.
151. Rashba EJ, Osman AF, MacMurdy K, et al. Exercise is superior to pacing for T wave alternans measurement in subjects with chronic coronary artery disease and left ventricular dysfunction. J Cardiovasc Electrophysiol 2002; 13:845-50.
152. Lauer MS, Topol EJ. Clinical trials:multiple treatments, multiple end points, and multiple lessons. JAMA 2003;289:2575-7.
153. Bloomfield DM, Steinman RC, Namerow PB, et al. Microvolt T-wave alternans distinguishes between patients likely and patients not likely to benefit from implanted cardiac defibrillator therapy:a solution to the Multicenter Automatic Defibrillator Implantation Trial (MADIT) Ⅱ conundrum. Circulation 2004; 110:1885-9.
154. Bloomfield DM, Bigger JT, Steinman RC, et al. Microvolt T-wave alternans and the risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction. J Am Coll Cardiol 2006;47:456-63.
155. Chow T, Kereiakes DJ, Bartone C, et al. Prognostic utility of microvolt T-wave alternans in risk stratification of patients with ischemic cardiomyopathy. J Am Coll Cardiol 2006;47:1820-7.
156. Gehi AK, Stein RH, Metz LD, Gomes JA. Microvolt T-wave alternans for the risk stratification of ventricular tachyarrhythmic events:a metaanalysis. J Am Coll Cardiol 2005;46:75-82.