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

doi:10.1016/j.jelectrocard.2018.07.012

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 language	English
Pages (from-to)	906-912
Number of pages	7
Journal	Journal of Electrocardiology
Volume	51
Issue number	5
DOIs	https://doi.org/10.1016/j.jelectrocard.2018.07.012
Publication status	Published - 1 Sept 2018
Externally published	Yes

Keywords

CMR
CTO
ECG
Hibernation
PCI
QT-dispersion

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10.1016/j.jelectrocard.2018.07.012

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van Dongen, I. M., Kolk, M. Z. H., Elias, J., Meijborg, V. M. F., Coronel, R., de Bakker, J. M. T., Claessen, B. E. P. M., Delewi, R., Ouweneel, D. M., Scheunhage, E. M., van der Schaaf, R. J., Suttorp, M. J., Bax, M., Marques, K. M., Postema, P. G., Wilde, A. A. M., & Henriques, J. P. S. (2018). The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial. Journal of Electrocardiology, 51(5), 906-912. https://doi.org/10.1016/j.jelectrocard.2018.07.012

@article{dcffaa46f49741f18137dffefa4aa47a,

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

abstract = "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.",

keywords = "CMR, CTO, ECG, Hibernation, PCI, QT-dispersion",

author = "{van Dongen}, {Ivo M.} and Kolk, {Maarten Z.H.} and Jo{\"e}lle Elias and Meijborg, {Veronique M.F.} and Ruben Coronel and {de Bakker}, {Jacques M.T.} and Claessen, {Bimmer E.P.M.} and Ronak Delewi and Ouweneel, {Dagmar M.} and Scheunhage, {Esther M.} and {van der Schaaf}, {Ren{\'e} J.} and Suttorp, {Maarten Jan} and Matthijs Bax and Marques, {Koen M.} and Postema, {Pieter G.} and Wilde, {Arthur A.M.} and Henriques, {Jos{\'e} P.S.}",

note = "Publisher Copyright: {\textcopyright} 2018",

year = "2018",

month = sep,

day = "1",

doi = "10.1016/j.jelectrocard.2018.07.012",

language = "English",

volume = "51",

pages = "906--912",

journal = "Journal of Electrocardiology",

issn = "0022-0736",

publisher = "Churchill Livingstone",

number = "5",

}

van Dongen, IM, Kolk, MZH, Elias, J, Meijborg, VMF, Coronel, R, de Bakker, JMT, Claessen, BEPM, Delewi, R, Ouweneel, DM, Scheunhage, EM, van der Schaaf, RJ, Suttorp, MJ, Bax, M, Marques, KM, Postema, PG, Wilde, AAM & Henriques, JPS 2018, 'The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial', Journal of Electrocardiology, vol. 51, no. 5, pp. 906-912. https://doi.org/10.1016/j.jelectrocard.2018.07.012

TY - JOUR

T1 - The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial

AU - van Dongen, Ivo M.

AU - Kolk, Maarten Z.H.

AU - Elias, Joëlle

AU - Meijborg, Veronique M.F.

AU - Coronel, Ruben

AU - de Bakker, Jacques M.T.

AU - Claessen, Bimmer E.P.M.

AU - Delewi, Ronak

AU - Ouweneel, Dagmar M.

AU - Scheunhage, Esther M.

AU - van der Schaaf, René J.

AU - Suttorp, Maarten Jan

AU - Bax, Matthijs

AU - Marques, Koen M.

AU - Postema, Pieter G.

AU - Wilde, Arthur A.M.

AU - Henriques, José P.S.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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.

AB - 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.

KW - CMR

KW - CTO

KW - ECG

KW - Hibernation

KW - PCI

KW - QT-dispersion

UR - http://www.scopus.com/inward/record.url?scp=85050259915&partnerID=8YFLogxK

U2 - 10.1016/j.jelectrocard.2018.07.012

DO - 10.1016/j.jelectrocard.2018.07.012

M3 - Article

C2 - 30177338

AN - SCOPUS:85050259915

SN - 0022-0736

VL - 51

SP - 906

EP - 912

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

IS - 5

ER -

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

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Keywords

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