Appropriate Care

At Cambridge Heart our goal is to help clinicians achieve appropriate care. Microvolt T-Wave Alternans (MTWA) testing represents an integral way for the cardiologist to determine the risk of sudden cardiac death. Multiple prospective clinical trials demonstrate the populations from a broad number of patient groups at risk of sudden cardiac death can be risk stratified for sudden cardiac death based on their results in Microvolt T-Wave Alternans testing.

Studies of both ischemic and non-ischemic patient groups show that the Negative Predictive Value of MTWA testing is superior to the negative predictive value of EP testing and the positive predictive value of MTWA testing is comparable to the gold standard of EP testing. These studies demonstrate that a patient who is negative for Microvolt T-Wave Alternans will likely live event-free for 12 to 24 months after their initial test. The ability to test that patient on regular basis such as annually means that patient would not likely benefit from ICD therapy as long as that result remains negative.

In patients who are at risk for sudden cardiac death, the use of ICDs for primary prevention represents a challenge to both the referring physician and implanting electrophysiologist. The cardiologist must determine which patients now eligible for an ICD (MADIT II and SCD-HeFT) are likely to benefit from this treatment. MTWA testing helps distinquish the level of risk for SCD and provides the caregiver a tool that can be used when consulting with the patient about the most appropriate care.

That an ICD is a life-altering intervention is not subject to debate. Though it offers the therapeutic advantage of detecting and correcting life threatening rhythm disturbances, the vast majority of recipients who receive an ICD never receive any therapeutic benefit from the device. In other words, the device never fires or fires inappropriately. In fact the results of the Multicenter Automatic Defibrillator Implantation Trial (MADIT II), demonstrated that it was necessary to implant 18 ICDs in order to save one life. Combine that low chance of receiving therapeutic benefit with the impact that an ICD can have on a patient's quality of life and you have the challenge for today's cardiologist - appropriate care in the face of a patient's real risk for sudden cardiac death.

Using MTWA testing allows you to stratify your patient's risk of sudden cardiac death and in the process deliver care that is most appropriate for each patient's risk profile.