Objective: Evaluation of the significance of the Wedensky Modulation (WM) examination for ventricular tachyarrhythmias (VT) in patients with coronary artery disease and implantable cardioverter-defibrillator therapy (ICD).
Design: Prospective, single-centre study conducted from 2004 to 2006.
Setting: University of Bonn, Department of Medicine – Cardiology, Bonn, Germany.
Patients: 37 consecutive patients with coronary artery disease receiving an ICD for primary or secondary prevention.
Main outcome measures: Correlation of a positive WM-Index (WMI) with established non-invasive Holter parameter, the occurrence of VT after ICD implantation with regard to primary or secondary prevention, and inducibility of VT during electrophysiological (EP) studies.
Results: The WMI was positive in 15 patients (67 (SD 8) years, 31% (SD 12%) EF) and showed significant correlation with heart rate variability (standard deviation of normal to normal intervals (SDNN): 143 (SD 80) ms vs 102 (SD 29) ms, p = 0.04, r = 0.45; total power (TP). 11 885 (SD 19 674) ms2 vs 2229 (SD 1779) ms2, p = 0.03, r = 0.384; very low frequency component (VLF): 2777 (SD 3039) ms2 vs 1184 (SD 565) ms2, p = 0.03; low frequency component (LF): 2955 (SD 5734) ms2 vs 468 (SD 725) ms2, p = 0.05, r = 0.375; high frequency component (HF): 4885 (SD 9939) ms2 vs 382 (SD 609) ms2, p = 0.05, r = 0.315) and turbulence (turbulence onset (TO): −0.002 (SD 0.008) vs +0.005 (SD 0.01), p = 0.05, r = 0.301; turbulence slope (TS): 3.4 (SD 3.1) vs 1.7 (SD 1.5), p = 0.04, r = 0.419). The positive predictive value of the WMI considering the inducibility of VT during EP testing was 100%. Those patients who received an ICD for primary prevention showed a higher WMI (p = 0.049) than the secondary prevention group. With respect to the occurrence of adequate VT episodes, a negative WM test result demonstrated a negative predictive value of 95%.
Conclusion: The data presented show that the WM-Index predicts VT inducibility during EP testing and indicates a high negative predictive value regarding the occurrence of VT.
- coronary artery disease
- implantable cardioverter-defibrillator (ICD)
- non-invasive risk stratification
- ventricular tachyarrhythmia (VT)
- Wedensky Modulation
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Competing interests: HH works for Harbinger Medical Inc.