Revascularisation of chronic total occlusions and recurrence rate of ventricular arrhythmias
Ward Eertmans1,2, Ief Hendrickx2, Ruben Pauwels3
1Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Insights
Revascularization for chronic total occlusions (CTO) may reduce ventricular arrhythmias (VA) in patients with VAs as the primary indication. This study suggests CTO treatment can improve patient outcomes by decreasing VA recurrence.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Ventricular arrhythmias (VA) pose a significant clinical challenge.
- The role of revascularization in chronic total occlusions (CTO) in managing VA is not well-understood.
Purpose of the Study:
- To investigate the recurrence rate of VA after CTO revascularization.
- To assess the impact of CTO treatment on patients with VA as the main clinical indication.
Main Methods:
- Retrospective analysis of prospectively gathered data from three Belgian CTO registries.
- Selection of patients with VA as the clinical indication for CTO revascularization.
- Definition of VA freedom and long-term outcome evaluation through patient record review.
Main Results:
- Out of 912 patients undergoing CTO-PCI, 43 (5%) presented with VA as the indication.
- At one-year follow-up (n=34), the overall VA recurrence rate was 38% (VES: 25%, non-sustained VT: 46%, sustained VT: 25%, Vfib: 60%).
Conclusions:
- CTO revascularization appears beneficial for patients with VA as the primary indication.
- This intervention may lead to a reduced incidence of VA and potentially improved patient outcomes.
Background:
The impact of revascularisation of chronic total occlusions (CTO) on the incidence of ventricular arrhythmias (VA) remains to be elucidated.
Methods:
Based on prospectively gathered data, the recurrence rate of VAs following CTO treatment was retrospectively investigated. Patients presenting with VAs as clinical indication for CTO revascularisation were retrospectively selected out of three Belgian CTO registries (i.e. Ziekenhuis Oost-Limburg, UZ Leuven and CHR de la Citadelle). Freedom of VAs was defined as absence of non-sustained or sustained tachycardias (VT), ventricular fibrillations (Vfib) and ventricular extrasystoles (VES; <2500 VES/24 h). Long-term outcome in terms of reoccurrence of VAs was evaluated by reviewing patient records.
Results:
Between 2011 and 2019, 912 patients underwent a CTO-PCI across three Belgian centres. In total 43 patients (5%) presented with VAs as clinical indication for CTO revascularisation. Overall follow-up was 723 (391 - 1144) days. Fourteen (33%), 18 (42%), 5 (11%) and 6 (14%) presented with >2500 VES/24 hrs, non-sustained VT, sustained VT and Vfib, respectively. In those patients with a one-year follow-up available (n = 34), overall recurrence rate of VAs was 38% (within VA group: VES: 25%, non-sustained VT: 46%; sustained VT: 25% and Vfib: 60%).
Conclusion:
Based on this retrospective data analysis, CTO revascularisation, in patients presenting with VAs as the main clinical indication, seems to beneficially impact the incidence of VAs, which ultimately might result in improved patients' outcome.
