Effect and benefit of percutaneous coronary intervention in chronic total occlusion on ventricular repolarization: QT
1College of Medicine, University of Baghdad, Baghdad, Iraq.
Insights
Percutaneous coronary intervention (PCI) significantly reduces corrected QT (QTc) dispersion in patients with chronic total coronary artery occlusion. This finding highlights PCI
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Background:
- ST segment, T wave, and QT interval changes are key electrocardiogram (ECG) parameters for diagnosing ischemic heart disease.
- Elevated QT dispersion, particularly corrected QT (QTc) dispersion, is linked to myocardial ischemia and coronary artery disease (CAD).
- Chronic total occlusion (CTO) presents a significant challenge in managing coronary artery disease.
Purpose of the Study:
- To evaluate changes in surface electrocardiography (ECG) parameters, specifically QTc dispersion, following percutaneous coronary intervention (PCI).
- To assess the impact of PCI on depolarization and repolarization variations in patients with CTO.
- To determine if PCI revascularization influences QTc dispersion in CTO patients.
Main Methods:
- A study involving 110 patients with CTO who underwent PCI revascularization at the Iraqi Center for Heart Disease (October 2020 - February 2021).
- Twelve-lead ECGs were recorded 12 hours before PCI and over one hour after the intervention.
- Measured parameters included corrected QT (QTc) interval durations and QTc dispersion, comparing pre- and post-PCI values.
Main Results:
- A statistically significant change was observed in average QTc interval and QTc dispersion before and after PCI.
- PCI revascularization in patients with CTO resulted in a major reduction in QTc dispersion.
- The study demonstrated a significant improvement in ECG repolarization parameters post-intervention.
Conclusions:
- Percutaneous coronary intervention is effective in reducing QTc dispersion in patients suffering from chronic total coronary artery occlusion.
- The reduction in QTc dispersion post-PCI suggests an improvement in myocardial electrical stability.
- ECG parameters like QTc dispersion can serve as valuable indicators of treatment efficacy in CTO patients undergoing PCI.
Abstract:
ST segment, T wave changes, QT interval changes, and QTc dispersion are among the parameters used to diagnose ischemic heart disease. The increase in the QT dispersion can be caused by myocardial ischemia, among other heart diseases, whereas cardiac diseases such as coronary artery disease (CAD) can be diagnosed by observing an abnormally high QTc dispersion. This study aimed to evaluate the variations in the QTc dispersion (depolarization and repolarization) of surface electrocardiography as a result of percutaneous coronary intervention (PCI) in patients with chronic total occlusion. This study took place in the Iraqi Center for Heart Disease from October 2020 to February 2021. 110 patients who suffered from chronic occlusion of the coronary artery and underwent PCI revascularization were examined. Twelve-lead electrocardiograms were recorded at the time of admission (12 hours before intervention) and more than one hour after the intervention. The measured ECG parameters included corrected QT interval durations and corrected QT dispersion in both pre and post-PCI electrocardiograms, and their values were compared. The average corrected QT interval and QTC dispersion changed significantly before and after the percutaneous coronary intervention. Performing percutaneous coronary intervention on patients who suffer from coronary artery total occlusion shows a major reduction in the corrected QT dispersion.
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