Vulnerability for ventricular arrhythmias in patients with chronic coronary total occlusion

Figures & data

Figure 1. Current recommendations for an ICD in patients with a CTO. Footnote. Based on the recommendations from the European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA) and Heart Rhythm Society (HRS) [29–31]. Abbreviations: EP, electrophysiology study; ICD, implantable cardioverter-defibrillator; LV, left ventricular; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NSVT, nonsustained ventricular tachycardia; NYHA, New York Heart Association; SCA, sudden cardiac arrest; VF, ventricular fibrillation; VT, ventricular tachycardia.

Table 1. CTO and appropriate ICD therapy/mortality in ICD recipients with coronary artery disease.

Study	Ref.	Year	Primary vs secondary prevention (%)	Study size (N)	Age (years)	Male (%)	LVEF (%)	CTO (%)	Median FU (years)	HR appropriate ICD therapy (95% CI)	HR all-cause mortality (95% CI)
Nombela-Franco	[6]	2012	100/0	162	62 ± 10	93	29 ± 9	44	2.2	3.5 (1.5–8.3)	5.6 (1.4–21.8)
Raja	[32]	2015	100/0	307	63 (59–69)	100	29 ± 7	37	4.1	0.8 (0.5–1.2)	1.7 (0.8–3.3)
Di Marco	[9]*	2017	100/0	108	59 ± 10	90	25 ± 5	31	2.8	3.64 (1.58–8.41)	1.49 (0.63–3.56)**
Di Marco	[10]*	2017	48/52	342	64 (57–71)	89	30 (25–38)	47	2.8	2.3 (1.6–3.3)	1.6 (0.99–2.6)**
Nombela-Franco	[5]	2017	0/100	425	69 (61–76)	92	39 ± 13	50	4.1	1.80 (1.30–2.50)	1.69 (1.04–2.73)
Yap	[7]	2017	0/100	217	63 ± 10	86	NA	33	5.1	2.07 (1.23–3.50)	0.97 (0.51–1.87)
Van Dongen	[33]	2018	74/26	722	66 ± 11	84	30 (25–37)	33	4	1.39 (1.06–1.83)	1.27 (0.996–1.62)

Continuous data are presented as mean±standard deviation or median (interquartile range). *The studies of Di Marco et al. focused on IRA-CTO [9,10]. All hazard ratios are based on multivariate analysis, except those marked with **. Abbreviations: CI, confidence interval; CTO, chronic total occlusion; HR, hazard ratio; LVEF, left ventricular ejection fraction; NA, not available.

Figure 2. Schematic overview of pro-arrhythmic effects of IRA-CTO and potential beneficial effects of CTO PCI.

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