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The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study

Ivo M van Dongen1, Maarten Z H Kolk1, Joëlle Elias1

  • 1Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.

Journal of Electrocardiology
|September 5, 2018
PubMed

Insights

Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) after ST-elevation myocardial infarction (STEMI) significantly reduced QT dispersion. This suggests CTO revascularization may decrease the risk of ventricular arrhythmias.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Interventional Cardiology

Background:

  • Chronic total occlusions (CTOs) are linked to increased ventricular arrhythmias.
  • Evaluating the impact of CTO revascularization on cardiac electrical activity is crucial.

Purpose of the Study:

  • To assess the effect of percutaneous coronary intervention (PCI) for CTOs on electrocardiographic (ECG) variables.
  • To determine if CTO revascularization influences the pro-arrhythmic substrate in STEMI patients.

Main Methods:

  • A randomized controlled trial (EXPLORE trial) involving STEMI patients with CTO.
  • Comparison of ECG variables and cardiac function at baseline and 4-month follow-up between CTO PCI and no-CTO PCI groups.

Main Results:

  • CTO PCI significantly reduced median QT dispersion at 4-month follow-up (46 ms vs. 54 ms).
  • No independent association was found between ECG variables and cardiac function.

Conclusions:

  • Revascularization of CTOs following STEMI shortens QT dispersion.
  • CTO revascularization may reduce the pro-arrhythmic substrate in patients with CTOs.
Abstract

Keywords:
CMRCTOECGHibernationPCIQT-dispersion

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