Table 1.
Theoretical Applicability and Published Clinical Studies on TWA Clustered by TWA Evaluation Methodology, Study Protocol for TWA Assessment and Clinical Population
| TWA Evaluation Methodology | |||||
|---|---|---|---|---|---|
| Pacing | Theoretical Applicability?* | SM Yes | CD Yes | MMA Yes | IBA Yes |
| Published clinical studies | Atrial | CARISMA substudy 74 | |||
| LVEF ≤ 40%, WMA 12 , 13 | EPS 68 , 75 , 80 | VT or SVT 104 | LVEF ≤ 40%, | ||
| LVEF ≤ 40%, EPS 66 ( # ) | CAD, EPS 76 , 101 | ICM, VT 103 | EPS 66 ( # ) | ||
| LVEF ≤ 35%, EPS 25 | Brugada 34 | ||||
| Ventricular | EPS 75 | ICD testing 73 | |||
| Atrial + Ventricular | CARISMA substudy 74 | ||||
| ICD electrogram 94 ( # ) | LVEF ≤ 40%, | LVEF ≤ 40%, | |||
| EPS 66 * | EPS 66 * | ||||
| Stress ECG | Theoretical Applicability?* | Yes | Yes | Yes | Yes |
|---|---|---|---|---|---|
| Published clinical studies | Not specified | REFINE 61 | MASTER I 26 | MACAS 37 | ABCD 24 |
| SCS 98 | Brugada 33 | ||||
| Ergometer | CARISMA substudy 74 | TWA in CHF 38 , 89 | ALPHA 39 | FINCAVAS | |
| MADIT‐2‐like 8 | Post‐MI 60 , 62 | Athletes 53 , 54 , 55 | Substudy 52 | ||
| Type 2 DM 58 , 59 | EPS 79 | Brugada 31 , 32 | |||
| Healthy subjects 49 , 50 | CHF 40 , 77 | CAD, EPS 76 | |||
| NIHD 42 , 43 , 44 , 95 , 100 | Pediatric 48 , 51 | ||||
| Treadmill | TWA in CHF 38 , 89 | ALPHA 39 | |||
| EPS 79 | CHF 77 | Post‐MI 60 | |||
| IHD, LVEF ≤ 35% 21 , 23 , 90 | Athletes 54 | ||||
| Pharmacological | Dobutamine 81 | Atropine 80 |
| Ambulatorial ECG | Theoretical Applicability?* | N.P. | Yes | Yes | Yes |
|---|---|---|---|---|---|
| Published clinical studies | ST‐T database | ATRAMI 92 (§) | ESVEM 72 § | ||
| Data analysis 84 | REFINE trial 61 | ||||
| EPHESUS 65 § | |||||
| Mental stress 93 | Mental stress 96 | ||||
| Guidelines 85 | Prior TV onset 71 |
Papers related to randomized trials (either trials originally involving TWA, specific substudies or data reanalyzes) or international databases are italicized. *= Evaluated according to the methodological principles framework published by Martinez and Olmos. 7
#= noncommercial algorithm implementation; §= TWA analysis of trial data (either partial or total); N.P. = not possible with the current commercial implementation of this methodology; LVEF = left ventricle ejection fraction; WMA = wall motion abnormalities; EPS = referred for electrophysiological study; CAD = coronary artery disease; ICM = ischemic cardiomyopathy; VT = ventricular tachycardia; SVT = supra‐ventricular tachycardia; ICD = implanted Cardio‐defibrillator; NIHD = nonischemic heart disease; IHD = ischemic heart disease; CHF = congestive heart failure.