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Friday, November 21, 2008

Heart Test Shows Who Needs Implantable Defibrillators

It also spots those patients who don't need the cardiac rhythm devices, study says.

By Randy Dotinga
HealthDay Reporter
Sunday, Mar. 25, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

SUNDAY, March 25 (HealthDay News) -- A new study provides more evidence that a special heart test could give cardiologists guidance on which patients need implanted defibrillators.

The research, which looks at patients who have weak heart muscles but no underlying coronary disease, suggests that the test, known as T-wave alternans, can predict which patients are at highest risk of suffering heart rhythm disorders. They can then get the implanted defibrillators, while the others could potentially avoid the procedure.

Still, more research is needed, said Dr. Andrea Russo, an electrophysiologist at the University of Pennsylvania. "We need more studies that are confirmatory before we start excluding patients from implantable defibrillators," she stressed.

A number of conditions, including viral infections and alcoholism, can weaken parts of the heart even when someone doesn't have clogged arteries. In some cases, there's no apparent cause.

People with this condition -- including some young people -- can suffer from abnormal heart rhythms and die. But doctors often try to boost their chances with implanted defibrillators designed to shock their hearts back into a proper rhythm when necessary.

Doctors have been looking for a way to predict which patients need defibrillators and which would be fine without them. Enter the T-wave test, which Russo said is similar to an EKG.

Patients typically undergo the test, which requires electrodes to be placed on the body, while exercising. According to Russo, it detects whether the heart's electrical system has the rough equivalent of a short circuit that could cause a heartbeat so fast that the heart can't handle it.

In the new study, Italian researchers examined what happened after 446 patients with heart failure -- defined here as moderate heart muscle damage -- were given the T-wave test. None of the patients had significant cardiovascular disease.

The findings were to be presented Sunday at the American College of Cardiology's annual meeting in New Orleans.

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