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Abstract Objective To explore the value of microvolt T-wave alternations (MTWA) in predicting malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). Methods 24-hour dynamic ECG was recorded and MTWA was tested in 105 healthy subjects (control group) and 97 patients with HCM(HCM group).Death, syncope and malignant arrhythmia were analyzed during follow-up 2 years. Results The upper limit of 95%confidence interval of MTWA was<36μV in control group. The number of patients with MTWA >36μV was 10.5% in control group and 55.3% in HCMgroup. 29 cases had malignant VA in HCMgroup and no one had cardiovascular events in control group. The sensitivity, specificity, positive predictive value and negative predictive value of MTWA >36μV in diagnosis of malignant VA were 79.3%, 55.4%, 44.2% and 85.7%, respectively. Conclusion The risk of malignant VA and sudden cardiac death increases in HCMpatients with abnormal MTWA.
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