20 ng/ml 200 ng/ml 1000 ng/ml chronic kidney disease CKD Brugada 5 Brugada Brugada 1
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1 Symposium Brugada 5 Brugada Brugada X brain natriuretic peptide BNP 20 ng/ml 200 ng/ml 1000 ng/ml chronic kidney disease CKD 2 CKD glomerular filtration rate GFR 60 ml/ /1.73m 2 30 ml/ /1.73m QRS J QT ST T T peak end Tp e QT dispersion QRS 120 msec J QRS Takanori Ikeda Risk stratification of sudden cardiac death global standard 1647
2 46 Symposium a. a. Brugada b. b. QT c. 4 c. QT d. d. J e. f. e. 2. a. 2. b. a. c. b a. 4. b. 5. c. a. d. b. e. 6. f a. 10. b. c. d. J QT 12 QT QT QTc 500 msec torsade de pointes QT QTc 300 msec Tp e V 5 T T 100 msec torsade de pointes 3 X X cardiothoracic ratio CTR 2 CTR BNP 1,000 ng/ml GFR 30 ml/ /1.73 m 2 12 QRS 120 msec J ST T QT 500 msec QT 300 msec T peak end 100 msec X mm 3000 / BNP GFR Simpson left ventricular ejection fraction LVEF 40 LVEF 55 mm 5 nonsustained 1648
3 Symposium ventricular tachycardia NSVT ventricular premature contraction VPC NSVT NSVT 3 VPC 100 / VPC 3000 / VPC NSVT 6 2 NSVT VPC LVEF LVEF LVEF 2 NSVT NSVT 8 NSVT 7 3 T wave alternans T wave alternans TWA T 1ABABAB 1649
4 48 Symposium 39 3 NYHA BNP T wave alternans 24 T wave alternans T wave variability late potentials 24 late potentials Heart rate turbulence TWA M TWA M TWA LVEF M TWA M TWA 8 ALPHA 9 MASTER 10 SCD HeFT 11 ABCD 12 SCD HeFT M TWA MASTER SCD HeFT ALPHA ABCD M TWA PREVENT SCD M TWA 4 M TWA TWA modified moving average MMA TWA TD TWA 13 TWA T wave variability 14 5 late potentials QRS late potentials LP 1650
5 Symposium LP LP LP LP 24 LP 15 CABG Patch 16 Brugada LP 17,18 6 heart rate variability HRV RR HRV HRV ATRAMI 19 HRV RR NN standard deviation of the NN inter vals SDNN 7 baroreceptor reflex sensitivity BRS 1 BRS BRS HRV ATRAMI 19 BRS 8 heart rate turbulence heart rate turbulence HRT1 VPC RR turbulence onset TO turbulence slope TS VPC VPC HRV VPC VPC 9 electrophysiologic study EPS 1651
6 50 Symposium 39 VT Brugada VF EPS MUSTT 22 EPS implantable cardioverter defibrillator ICD EPS 22 EPS MADIT II 23 EPS ICD p CKD p Circ J 2005;69 Suppl IV: ACC/AHA/ESC 2006 Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. J Am Coll Cardiol 2006; 48 Issue 5: e Ikeda T, Yusu S, Nakamura K, et al. Risk stratification for sudden cardiac death. Circ J 2007;71 Suppl A: A Ikeda T, Saito H, Tanno K, et al. T wave alternans as a predictor for sudden cardiac death after myocardial infarction. Am J Cardiol 2002;89: Scirica BM, Braunwald E, Belardinelli L, et al. Relationship between nonsustained ventricular tachycardia after non ST elevation acute coronary syndrome and sudden cardiac death: obser vations from the metabolic efficiency with ranolazine for less ischemia in non ST elevation acute coronary syndrome thrombolysis in myocardial infarction 36 MERLIN TIMI 36 randomized controlled trial. Circulation 2010;122: Ikeda T, Yoshino H, Sugi K, et al. Predictive value of microvolt T wave alternans for sudden cardiac death in patients with preserved cardiac function after acute myocardial infarction: results of a collaborative cohort study. J Am Coll Cardiol 2006;48: Salerno Uriarte JA, De Ferrari GM, Klersy C, et al. Prognostic value of T wave alternans in patients with heart failure due to nonischemic cardiomyopathy: results of the ALPHA Study. J Am Coll Cardiol 2007;50: Chow T, Kereiakes DJ, Onufer J, et al. Does microvolt T wave alternans testing predict ventricular tachyarrhythmias in patients with ischemic cardiomyopathy and prophylactic defibrillators? The MASTER Microvolt T Wave Alternans Testing for Risk Stratification of Post Myocardial Infarction Patients trial. J Am Coll Cardiol 2008;52: Gold MR, Ip JH, Costantini O, et al. Role of microvolt T wave alternans in assessment of arrhythmia vulnerability among patients with heart failure and systolic dysfunction: primary results from the T wave alternans sudden cardiac death in heart failure trial substudy. Circulation 2008;118: Costantini O, Hohnloser SH, Kirk MM, et al. The ABCD Alternans Before Cardioverter Defibrillator Trial: Strategies using T wave alternans to improve efficiency of sudden cardiac death prevention. J Am Coll Cardiol 2009;53: Sakaki K, Ikeda T, Miwa Y, et al. 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; Couderc JP, Zareba W, McNitt S, et al. Repolarization variability in the risk stratification of MADIT II patients. Europace 2007;9: Abe A, Ikeda T, Tsukada T, et al. Circadian variation of late potentials in idiopathic ventricular fibrillation associated with J waves: Insights into pathophysiology and risk stratification. Heart Rhythm 2010;7: Ikeda T, Sakata T, Takami M, et al. Combined assessment of T wave alternans and late potentials used to predict arrhythmic events after myocardial 1652
7 Symposium infarction: A prospective study. J Am Coll Cardiol 2000;35: Bigger JT; the Coronar y Ar ter y 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: Ikeda T, Sakurada H, Sakabe K, et al. Assessment of noninvasive markers in identifying patients at risk in the Brugada syndrome: Insight into risk stratification. J Am Coll Cardiol 2001;37: La Rovere MT, Bigger JT Jr, et al; for the 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: Schmidt G, Malik M, Barthel P, Schneider R, Ulm K, Rolnitzky L, et al. Heart rate turbulence after ven tricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet 1999;353: Miwa Y, Ikeda T, Sakaki K, Miyakoshi M, Ishiguro H, Tsukada T, et al. Heart rate turbulence as a predictor of cardiac mortality and arrhythmic events in patients with dilated cardiomyopathy: A prospective study. J Cardiovasc Electrophysiol 2009;20: Buxton AE, Lee KL, DiCarlo L, et al. Multicenter Unsustained Tachycardia Trial Investigators. Electrophysiologic testing to identify patients with coronary artery disease who are at risk for sudden death. N Engl J Med 2000;342: Daubert JP, Zareba W, Hall WJ, et al. Predictive value of ventricular arrhythmia inducibility for subsequent ventricular tachycardia or ventricular fibrillation in Multicenter Automatic Defibrillator Implantation Trial MADIT II patients. Am Coll Cardiol 2006;47:
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/$ -see front matter 2011 Heart Rhythm Society. All rights reserved. doi: /j.hrthm
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