TY - JOUR
T1 - Incidence of ventricular arrhythmias in patients with chronic total coronary occlusion
T2 - Results of the VACTOR study
AU - Assaf, Amira
AU - Sakhi, Rafi
AU - Diletti, Roberto
AU - Hirsch, Alexander
AU - Allaart, Cornelis P.
AU - Bhagwandien, Rohit
AU - Firouzi, Mehran
AU - Smits, Pieter C.
AU - Hoogendijk, Mark G.
AU - Theuns, Dominic A. M. J.
AU - Yap, Sing-Chien
N1 - Publisher Copyright: © 2023 The Authors
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Background: A chronic total coronary occlusion (CTO) is associated with ventricular arrhythmias (VA) in patients with an implantable cardioverter-defibrillator (ICD). Limited data is available on the incidence of VA in CTO patients without an ICD. Objectives: To investigate the incidence of sustained VA in CTO patients after successful CTO revascularization and in patients with untreated CTO or failed CTO revascularization. Methods: Prospective, multicenter observational pilot study including CTO patients who were not eligible for an ICD and had a left ventricular ejection fraction >35 %. We enrolled patients with a successful CTO revascularization (group A) and patients with untreated CTO or failed CTO revascularization (group B). All patients received an implantable loop recorder with remote monitoring. The primary endpoint was sustained VA. Results: Ninety patients were enrolled (mean age 63 ± 10 years, 83.3 % man, mean LVEF 55 ± 8 %). Group A (n = 45) had a higher prevalence of CTO in the left anterior descending artery in comparison to group B (n = 45) (28.9 % versus 4.4 %, P = 0.002). Other baseline characteristics were similar. During a median follow-up time of 26 months (IQR, 19–35), five patients (5.6 %) had a sustained VA. There was no difference in the incidence of sustained VA between groups (3-year cumulative event rate: 8.8 % (group A) versus 4.5 % (Group B), log-rank P = 0.71). Conclusion: Patients with an CTO, who do not qualify for an ICD, have a substantial risk of sustained VA. In our study the incidence was not different between patients with revascularized and those with untreated CTO.
AB - Background: A chronic total coronary occlusion (CTO) is associated with ventricular arrhythmias (VA) in patients with an implantable cardioverter-defibrillator (ICD). Limited data is available on the incidence of VA in CTO patients without an ICD. Objectives: To investigate the incidence of sustained VA in CTO patients after successful CTO revascularization and in patients with untreated CTO or failed CTO revascularization. Methods: Prospective, multicenter observational pilot study including CTO patients who were not eligible for an ICD and had a left ventricular ejection fraction >35 %. We enrolled patients with a successful CTO revascularization (group A) and patients with untreated CTO or failed CTO revascularization (group B). All patients received an implantable loop recorder with remote monitoring. The primary endpoint was sustained VA. Results: Ninety patients were enrolled (mean age 63 ± 10 years, 83.3 % man, mean LVEF 55 ± 8 %). Group A (n = 45) had a higher prevalence of CTO in the left anterior descending artery in comparison to group B (n = 45) (28.9 % versus 4.4 %, P = 0.002). Other baseline characteristics were similar. During a median follow-up time of 26 months (IQR, 19–35), five patients (5.6 %) had a sustained VA. There was no difference in the incidence of sustained VA between groups (3-year cumulative event rate: 8.8 % (group A) versus 4.5 % (Group B), log-rank P = 0.71). Conclusion: Patients with an CTO, who do not qualify for an ICD, have a substantial risk of sustained VA. In our study the incidence was not different between patients with revascularized and those with untreated CTO.
KW - Chronic total coronary occlusion
KW - Implantable cardioverter-defibrillator
KW - Myocardial infarction
KW - Percutaneous coronary intervention
KW - Sudden cardiac death
KW - Ventricular arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85180333167&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcha.2023.101323
DO - https://doi.org/10.1016/j.ijcha.2023.101323
M3 - Article
C2 - 38188347
SN - 2352-9067
VL - 50
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
M1 - 101323
ER -