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Published on: June 28, 2019
Effect of coronary revascularization on electrocardiographic parameters in patients with chronic total occlusion
Burak Ayca1, Yasin Yüksel2, Cennet Yıldız3
1Department of Cardiology, Private Medical Point Hospital, Yeni Girne Bulvarı, 1825. Sk No. 12, 35575 Karşıyaka/İzmir, Türkiye.
Insights
Successful revascularization of chronic total occlusion (CTO) significantly improves electrocardiographic parameters, reducing arrhythmia risk. This procedure also enhances left ventricular ejection fraction (LVEF), indicating better heart function post-intervention.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Chronic total occlusion (CTO) interventions aim to improve patient quality of life and cardiac function.
- Electrocardiographic parameters can reflect myocardial electrical stability and predict arrhythmias.
Purpose of the Study:
- To investigate the impact of percutaneous coronary intervention (PCI) for CTO on various electrocardiographic parameters.
- To assess changes in QT dispersion (QTD), P-wave dispersion (PWD), and T-wave peak-to-end (Tp-Te) interval after CTO revascularization.
Main Methods:
- Collected data from 133 patients undergoing successful CTO PCI.
- Measured QTD, PWD, Tp-Te interval, and Tp-Te/QT ratio before and 7 days after PCI.
- Analyzed changes in these parameters and left ventricular ejection fraction (LVEF), stratifying by Rentrop grades.
Main Results:
- Successful CTO revascularization significantly reduced PWD and Tp-Te interval/QT ratio (P < .001).
- Corrected QT interval and QTDc also decreased post-PCI.
- LVEF improved significantly (P = .001), and Rentrop Group 1 showed higher PWD and QTDc values.
- Age and SYNTAX score predicted QTDc difference.
Conclusions:
- Successful CTO revascularization favorably impacts arrhythmia generation by improving electrical stability.
- The procedure leads to enhanced left ventricular ejection fraction (LVEF).
- Electrocardiographic improvements suggest reduced risk of cardiac arrhythmias post-intervention.
Purpose:
Substantial evidence suggests that revascularization of chronic total occlusion (CTO) leads to improvement of quality of life and ventricular function. We studied the effect of revascularization on electrocardiographic parameters in patients with CTO.
Study Design:
The data of patients who underwent CTO percutaneous intervention (PCI) were collected. QT dispersion (QTD), P-wave dispersion (PWD), T-wave peak-to-end (Tp - Te) interval, and Tp - Te/QT ratio were calculated for each patient before and 7 days after the intervention. Patients were divided into two groups according to their Rentrop grades.
Results:
One hundred and thirty three patients underwent successful CTO intervention. Their mean age was 61.88 ± 10.53 years, the median left ventricular ejection fraction (LVEF) was 55 (43.00-60.00). After revascularization, P-wave maximum, minimum duration, and PWD were significantly reduced. We found no difference in QRS duration between the pre- and post-PCI periods (P = .522). Corrected QT interval, QTc maximum, minimum time, and QTDc were all reduced after PCI. Tp - Te interval and Tp - Te/QT ratio were also found to decrease after successful revascularization (P < .001 for both). LVEF increased from 52.00 (42.75-60.00) to 55.00 (45.00-60.00) (P = .001). Compared to patients in Rentrop Group 2, patients in Group 1 had increased values for PWD before the procedure and for QTDc before and after the procedure. Multivariable linear regression analysis revealed that age and the SYNTAX score were predictors of the QTDc difference.
Conclusions:
Our findings supported the evidence that successful revascularization of CTO could lead to favorable effect on arrhythmia generation and LVEF.
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