T-wave alternans predicts ICD discharge in MADIT II patients with elevated resting heart rate

The identification of MADIT II patients who might benefit the most from implantable cardioverter defibrillator (ICD) therapy remains a clinical challenge. In this work we measure T-wave alternans (TWA) using the multilead Laplacian likelihood ratio method (mLLR) in MADIT II patients, and we evaluate its ability to predict ventricular tachycardia or ventricular fibrillation events requiring an ICD shock and to predict sudden cardiac death (SCD). Our results indicate that the average TWA measured between 80 and 90 beats/min in resting ECGs is associated with future ICD therapy in MADIT II patients with elevated resting heart rate.