New Noninvasive Test Helps Predict Risk of Sudden Cardiac Death

An inexpensive new test uses computer technology to gauge the risk of sudden cardiac death. The test of the heart’s electrical system in individuals with history of heart damage helps doctors decide who needs an implanted cardioverter defibrillator (ICD).

When a person with an ICD experiences dangerously abnormal cardiac rhythm, the device delivers an electrical jolt that shocks the heart back to normal rhythm. Sudden cardiac death kills about 325,000 adults in the U.S. each year – primarily persons who do not have the implanted device.

Until now, cardiac screening of large populations for risk of sudden cardiac death has been expensive and impractical. This new technology could make such screenings more affordable and feasible.


A study involving 500 patients with some heart damage using the more invasive electrophysiological screenings as well as the new, computerized technology came to a close recently. The new testing techniques proved to be just as accurate, according to a professor of medicine at the American Heart Association’s annual meeting.

In the older test, a catheter is inserted through a small incision in the vein and threaded to the heart to measure electrical activity. The new test, called the microvolt T wave alternans (MTWA), measures the electrical discharge of a person’s T-waves from one beat to the next. This individualized risk information allows doctors to determine which patients might benefit from an implanted ICD.

The predictive accuracy of both tests is comparable. The main difference is that the latest test is simple, noninvasive and cheap, while the other is invasive, expensive and risky. In complicated cases, some doctors use both tests. When both technologies confirm the need for an ICD, the surgery is performed.

Physicians hope that in the future, the newer technology may be able to replace electrophysiological screening altogether. At this point, two tests are still better than one.

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