Background: Observational studies suggest that in patients with a CTO successful recanalization is associated with better clinical outcome. This could be related to a reduction in the occurrence of arrhythmias, which may result from modifications of the hibernating myocardium in a CTO region.
Methods And Results: We aimed to evaluate the effect of CTO PCI on electrophysiological parameters, and conducted a systematic review and meta-analysis according to the PRISMA guidelines. MEDLINE and EMBASE were searched. Titles and abstracts identified by the search strategy were independently screened by two investigators. Data were extracted and used for meta-analyses where possible. In total, eight studies incorporating 467 patients were included in this review, evaluating the effect of successful CTO PCI on various ECG parameters. Three studies showed a significant decrease in mean QT dispersion of 17.46ms [95% CI 10.62-24.30] after successful CTO PCI. QTc dispersion also decreased significantly, with a mean decrease of 18.74ms [95% CI 11.53-25.94]. In one trial a significant decrease in Tp-e interval in leads V2 and V5, and a significant decrease in Tp-e/QT ratio in leads V2 and V5 post-CTO PCI were observed.
Conclusions: This first systematic review and meta-analysis suggests that successful CTO PCI is associated with an immediate decrease in ECG parameters that reflect heterogeneity in depolarization and repolarization, which could lead to a reduction in the risk for ventricular arrhythmias and sudden cardiac death. We raise the hypothesis that hibernating myocardium in a CTO region may not be as deeply "in sleep" as one would assume.
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http://dx.doi.org/10.1016/j.carrev.2017.09.004 | DOI Listing |
Int J Cardiol Cardiovasc Risk Prev
March 2025
Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Background: Transcatheter aortic valve replacement (TAVR) has significantly advanced the treatment of severe aortic stenosis (AS), particularly in elderly patients who often have coexisting coronary artery disease (CAD). Chronic total occlusion (CTO), a severe form of CAD, may negatively impact outcomes in TAVR patients, though data are limited. This meta-analysis aims to evaluate the impact of CTO on TAVR outcomes.
View Article and Find Full Text PDFTunis Med
January 2025
Cardiology department, Habib Thameur teaching hospital, Tunis, Tunisia. Faculty of medicine of Tunis, University of Tunis El Manar.
Introduction: In recent years, advancements in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have been notable, improving procedural techniques, imaging, and management of complications.
Aim: We sought to assess the performance and the practice of a high-volume Tunisian PCI center in treating patients with a CTO.
Methods: We retrospectively evaluated data from consecutive CTO patients who underwent percutaneous revascularization from October 2019 to January 2024 at the cardiology department of Habib Thameur Teaching Hospital, Tunisia.
Int J Cardiol
January 2025
Department of Cardiology, University Hospital Královské Vinohrady, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Background And Aims: Myocardial infarction (MI) in multivessel disease (MVD) and chronic total occlusion (CTO) is associated with high mortality. However, all-cause mortality of matched cohort without a CTO is unclear. Our aim was to analyse clinical characteristics, presenting symptoms, and survival of patients with MI in MVD and the possible impact of CTO on 1-year mortality.
View Article and Find Full Text PDFJ Invasive Cardiol
January 2025
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota. Email:
Background: The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI).
Methods: The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436).
Results: The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.
J Soc Cardiovasc Angiogr Interv
December 2024
Department of Cardiology, HonorHealth/Scottsdale Shea Medical Center, Scottsdale, Arizona.
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is high risk compared to non-CTO PCI. Iatrogenic coronary artery hematoma formation is a common occurrence during CTO PCI, impairing true lumen visualization. We describe the use of a continuous mechanical suction (CMS) device in 2 applications in which it was used for successful subintimal hematoma decompression and distal vessel re-entry.
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