Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)

BackgroundPrevious studies report conflicting results about a higher incidence of ventricular arrhythmias in patients with a chronic total coronary occlusion (CTO). We aimed to investigate this association in a large cohort of implantable cardioverter defibrillator patients with long‐term follow‐up....

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Autores principales:	Ivo M. van Dongen, Dilek Yilmaz, Joëlle Elias, Bimmer E. P. M. Claessen, Ronak Delewi, Reinoud E. Knops, Arthur A. M. Wilde, Lieselot van Erven, Martin J. Schalij, José P. S. Henriques
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	chronic total coronary occlusion implantable cardioverter‐defibrillator ischemic cardiomyopathy mortality ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/767b16fbb76a4230b50171d574107ba4
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spelling	oai:doaj.org-article:767b16fbb76a4230b50171d574107ba42021-11-12T17:01:48ZEvaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)10.1161/JAHA.118.0086092047-9980https://doaj.org/article/767b16fbb76a4230b50171d574107ba42018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.118.008609https://doaj.org/toc/2047-9980BackgroundPrevious studies report conflicting results about a higher incidence of ventricular arrhythmias in patients with a chronic total coronary occlusion (CTO). We aimed to investigate this association in a large cohort of implantable cardioverter defibrillator patients with long‐term follow‐up. Methods and ResultsAll consecutive patients from 1992 onwards who underwent implantable cardioverter defibrillator implantation for ischemic cardiomyopathy at the Leiden University Medical Center were evaluated. Coronary angiograms were reviewed for the presence of a CTO. The occurrence of ventricular arrhythmias and survival status at follow‐up were compared between patients with and patients without a CTO. A total of 722 patients constitute the study cohort (age 66±11 years; 84% males; 74% primary prevention, median left ventricular ejection fraction 30% [first–third quartile: 25–37], 44% received a cardiac resynchronization therapy defibrillator). At baseline, 240 patients (33%) had a CTO, and the CTOs were present for at least 44 (2–127) months. The median follow‐up duration was 4 (2–6) years. On long‐term follow‐up, CTO patients had a higher crude appropriate device therapy rate (37% versus 27%, P=0.010) and a lower crude survival rate (51% versus 67%, P<0.001) compared with patients without a CTO. Corrected for baseline characteristics including left ventricular ejection fraction, the presence of a CTO was an independent predictor for appropriate device therapy. ConclusionsThe presence of a CTO in implantable cardioverter defibrillator patients was associated with more appropriate device therapy and worse prognosis at long‐term follow‐up. Further investigation is warranted regarding a potential beneficial effect of CTO revascularization on the incidence of ventricular arrhythmias.Ivo M. van DongenDilek YilmazJoëlle EliasBimmer E. P. M. ClaessenRonak DelewiReinoud E. KnopsArthur A. M. WildeLieselot van ErvenMartin J. SchalijJosé P. S. HenriquesWileyarticlechronic total coronary occlusionimplantable cardioverter‐defibrillatorischemic cardiomyopathymortalityventricular arrhythmiaDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic total coronary occlusion implantable cardioverter‐defibrillator ischemic cardiomyopathy mortality ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	chronic total coronary occlusion implantable cardioverter‐defibrillator ischemic cardiomyopathy mortality ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701 Ivo M. van Dongen Dilek Yilmaz Joëlle Elias Bimmer E. P. M. Claessen Ronak Delewi Reinoud E. Knops Arthur A. M. Wilde Lieselot van Erven Martin J. Schalij José P. S. Henriques Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
description	BackgroundPrevious studies report conflicting results about a higher incidence of ventricular arrhythmias in patients with a chronic total coronary occlusion (CTO). We aimed to investigate this association in a large cohort of implantable cardioverter defibrillator patients with long‐term follow‐up. Methods and ResultsAll consecutive patients from 1992 onwards who underwent implantable cardioverter defibrillator implantation for ischemic cardiomyopathy at the Leiden University Medical Center were evaluated. Coronary angiograms were reviewed for the presence of a CTO. The occurrence of ventricular arrhythmias and survival status at follow‐up were compared between patients with and patients without a CTO. A total of 722 patients constitute the study cohort (age 66±11 years; 84% males; 74% primary prevention, median left ventricular ejection fraction 30% [first–third quartile: 25–37], 44% received a cardiac resynchronization therapy defibrillator). At baseline, 240 patients (33%) had a CTO, and the CTOs were present for at least 44 (2–127) months. The median follow‐up duration was 4 (2–6) years. On long‐term follow‐up, CTO patients had a higher crude appropriate device therapy rate (37% versus 27%, P=0.010) and a lower crude survival rate (51% versus 67%, P<0.001) compared with patients without a CTO. Corrected for baseline characteristics including left ventricular ejection fraction, the presence of a CTO was an independent predictor for appropriate device therapy. ConclusionsThe presence of a CTO in implantable cardioverter defibrillator patients was associated with more appropriate device therapy and worse prognosis at long‐term follow‐up. Further investigation is warranted regarding a potential beneficial effect of CTO revascularization on the incidence of ventricular arrhythmias.
format	article
author	Ivo M. van Dongen Dilek Yilmaz Joëlle Elias Bimmer E. P. M. Claessen Ronak Delewi Reinoud E. Knops Arthur A. M. Wilde Lieselot van Erven Martin J. Schalij José P. S. Henriques
author_facet	Ivo M. van Dongen Dilek Yilmaz Joëlle Elias Bimmer E. P. M. Claessen Ronak Delewi Reinoud E. Knops Arthur A. M. Wilde Lieselot van Erven Martin J. Schalij José P. S. Henriques
author_sort	Ivo M. van Dongen
title	Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
title_short	Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
title_full	Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
title_fullStr	Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
title_full_unstemmed	Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long‐Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter‐Defibrillator (the <styled-content style="fixed-case">eCTO</styled-content>py‐in‐<styled-content style="fixed-case">ICD</styled-content> Study)
title_sort	evaluation of the impact of a chronic total coronary occlusion on ventricular arrhythmias and long‐term mortality in patients with ischemic cardiomyopathy and an implantable cardioverter‐defibrillator (the <styled-content style="fixed-case">ecto</styled-content>py‐in‐<styled-content style="fixed-case">icd</styled-content> study)
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/767b16fbb76a4230b50171d574107ba4
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