Why the study?
Does percutaneous coronary intervention of a chronic total occlusion improve electrocardiographic variables in STEMI patients with a concomitant CTO?
Does percutaneous coronary intervention of a chronic total occlusion improve electrocardiographic variables in STEMI patients with a concomitant CTO?
Revascularization of a concurrent CTO in STEMI patients significantly shortens QT dispersion at 4 months, suggesting a potential reduction in the pro-arrhythmic substrate.
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CTO PCI may lower arrhythmic risk in STEMI with concomitant CTO; extends randomized evidence on revascularization effects.
INTRODUCTION: Chronic total coronary occlusions (CTOs) have been associated with a higher prevalence of ventricular arrhythmias compared to patients without a CTO. We evaluated the effect of CTO revascularization on electrocardiographic (ECG) variables. METHODS: We studied a selection of ST-elevation myocardial infarction patients with a concomitant CTO enrolled in the EXPLORE trial. ECG variables and cardiac function were analysed at baseline and at 4 months follow-up. RESULTS: Patients were randomized to percutaneous coronary intervention (PCI) of their CTO (n = 77) or to no-CTO PCI (n = 81). At follow-up, median QT dispersion was significantly lower in the CTO PCI group compared to the no-CTO PCI group (46 ms [33-58] vs. 54 ms [37-68], P = 0.043). No independent association was observed between ECG variables and cardiac function. CONCLUSION: Revascularization of a CTO after STEMI significantly shortened QT dispersion at 4 months follow-up. These findings support the hypothesis that CTO revascularization reduces the pro-arrhythmic substrate in CTO patients.
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Dongen et al. (2018) studied this question.
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