The Wedensky test predicts malignant ventricular arrhythmias after myocardial infarction

Scand Cardiovasc J. 2013 Oct;47(5):256-62. doi: 10.3109/14017431.2013.831117.

Abstract

Objectives: Better tools are needed for detection of future malignant ventricular arrhythmias post myocardial infarct (MI). Wedensky Modulation (WM) is a new semi-invasive method: A short low-amplitude electrical impulse is applied synchronized to the QRS between a precordial and dorsal thoracic patch, and changes in the following QRS-T are registered.

Design: A total of 357 (MI) ICD patients underwent WM testing. QRS-T wavelet analysis provided WM Indexes for the QRS complex (WMI-R) and T wave (WMI-T). Outcome was the time to first occurrence of appropriate device therapy for ventricular arrhythmia. Patients were followed at 6-month intervals for 2 years.

Results: No arrhythmia was induced by the testing. Two-year appropriate arrhythmia treatment occurred in 35% (WMI-R positive) versus 25% (WMI-R negative, p = 0.014), and. 45% versus 26% (p = 0.001) for WMI-T positive versus negative. Two-year event rates of WMI-R or WMI-T positive versus WMI-R and WMI-T negative were 36% versus 22% (p = 0.004). In Cox proportional hazard model, the combination of WMI-R and WMI-T was the only statistically significant event predictor (p = 0.003).

Conclusion: Potentially life-threatening ventricular arrhythmic events could be predicted by the WM test. In combination with other risk factors WMI may be useful in these patients.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Aged
  • Arrhythmias, Cardiac*
  • Defibrillators, Implantable*
  • Female
  • Heart Function Tests*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology
  • Patient Selection
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Stroke Volume
  • Ventricular Function, Left