T-wave alternans may help identify some patients who don’t need an ICD

T-wave alternans (TWA) is still on the long and winding road to widespread clinical acceptance, and there’s no end to its journey in sight right now. The ABCD (Alternans Before Cardioverter Defibrillator) Trial has been published in JACC. The study investigators, and the editorialists, agree that TWA has promise, but that it can not yet be used to identify patients who don’t need an ICD.


  1. brian hassine says

    Ive studied MTWA for years and the fact is there isnt one patient in the world who’s doctor has determined already needs an icd, that shouldnt be told there is a test that could help your decision process, AT THE VERY LEAST…Its also insulting to intelligent people who arent doctors to think that some doctors think its okay to implant their patients based on ef<30 and not at the very least have them take a simple treadmill test which wouldnt hurt anyone, and which add AT THE VERY LEAST more insight to the life changing decision to get an icd…Most people who make a choice to have some type of surgery, walk out in better shape than when they went in and have no remnants of their surgery that they will live with. An ICD by its very nature, is life altering to the end, and your life, for better or for worse will never be the same ultimately..You would think good doctors, good fellow men would want all the possible diagnostic information available, to make the best choices for their patients, especially tests which are harmless and paid for by the federal gvt, yet simutaneously these same doctors study alternans itself and understand it is an underlying cause of scd, but choose not to test their patients. That policy can only last so long.

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