The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial

Ivo M. van Dongen, Maarten Z. H. Kolk, Joëlle Elias, Veronique M. F. Meijborg, Ruben Coronel, Jacques M. T. de Bakker, Bimmer E. P. M. Claessen, Ronak Delewi, Dagmar M. Ouweneel, Esther M. Scheunhage, René J. van der Schaaf, Maarten-Jan Suttorp, Matthijs Bax, Koen M. Marques, Pieter G. Postema, Arthur A. M. Wilde, José P. S. Henriques

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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.
Original languageEnglish
Pages (from-to)906-912
JournalJournal of electrocardiology
Issue number5
Publication statusPublished - 2018

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