Revascularisation of chronic total occlusions and recurrence rate of ventricular arrhythmias

Abstract

Background

The impact of revascularisation of chronic total occlusions (CTO) on the incidence of ventricular arrhythmias (VA) remains to be elucidated.

Methods

Based on prospectively gathered data, the recurrence rate of VAs following CTO treatment was retrospectively investigated. Patients presenting with VAs as clinical indication for CTO revascularisation were retrospectively selected out of three Belgian CTO registries (i.e. Ziekenhuis Oost-Limburg, UZ Leuven and CHR de la Citadelle). Freedom of VAs was defined as absence of non-sustained or sustained tachycardias (VT), ventricular fibrillations (Vfib) and ventricular extrasystoles (VES; <2500 VES/24 h). Long-term outcome in terms of reoccurrence of VAs was evaluated by reviewing patient records.

Results

Between 2011 and 2019, 912 patients underwent a CTO-PCI across three Belgian centres. In total 43 patients (5%) presented with VAs as clinical indication for CTO revascularisation. Overall follow-up was 723 (391 − 1144) days. Fourteen (33%), 18 (42%), 5 (11%) and 6 (14%) presented with >2500 VES/24 hrs, non-sustained VT, sustained VT and Vfib, respectively. In those patients with a one-year follow-up available (n = 34), overall recurrence rate of VAs was 38% (within VA group: VES: 25%, non-sustained VT: 46%; sustained VT: 25% and Vfib: 60%).

Conclusion

Based on this retrospective data analysis, CTO revascularisation, in patients presenting with VAs as the main clinical indication, seems to beneficially impact the incidence of VAs, which ultimately might result in improved patients’ outcome.

Keywords:

• Chronic total occlusion
• revascularisation
• ventricular arrhythmias

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Limburg Clinical Research Programme (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital.