Microvolt T-wave alternans testing provides a reliable means of guiding anti-arrhythmic therapy

Gupta et al1 present a meta-analysis and conclude that microvolt T-wave alternans testing (MTWA) does not modify risk of sudden cardiac death (SCD) sufficiently for clinical use. Their analysis involves a number of methodological limitations. The authors included in their primary analysis numerous surrogates for sudden cardiac death (SCD) such as ICD therapy, cardiac mortality and total mortality