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Heeding the Messages from PREVENT‐SCD

The recently published PREVENT-SCD study reported on the prognostic value of T-wave alternans (TWA) for lethal ventricular arrhythmias (LVA) in a group of 453 enrolled patients with ischemic or nonischemic cardiomyopathies and a left ventricular ejection fraction (LVEF) ≤ 40%.1 The study was multicenter, with participation of 37 hospitals, prospective, and observational in design, with clear patient selection and exclusion criteria, and with the only limitation that no data on the number, characteristics, and outcome of the patients screened and excluded in this study were recorded. It is unlikely that one could improve by designing a better and larger study, and thus it is possible that we should resort to finding solutions of our remaining questions on LVA via a large national or international registry, where every patient encountered is entered. The authors confirmed what is currently known about the very high event-free rate for LVA for patients with a TWA-negative test and a similarly lower event-