Incidence and characteristics of ventricular tachycardia in patients after percutaneous coronary revascularization of chronic total occlusions


Autoři: Sebastian König aff001;  Enno Boudriot aff002;  Arash Arya aff001;  Julia-Anna Lurz aff001;  Marcus Sandri aff002;  Sandra Erbs aff002;  Holger Thiele aff002;  Gerhard Hindricks aff001;  Borislav Dinov aff001
Působiště autorů: Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Sachsen, Germany aff001;  Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Sachsen, Germany aff002;  Leipzig Heart Institute, Leipzig, Sachsen, Germany aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225580

Souhrn

Objectives

This study sought to investigate the prevalence of ventricular tachycardia after percutaneous coronary intervention (PCI) of chronic total occlusion (CTO).

Background

PCI of a CTO is associated with improvement of the left ventricular ejection fraction and possibly associated with reduced mortality. However, benefits of CTO-PCI must be weighed against a higher risk of procedure-related complications. The incidence of new-onset ventricular tachycardia after a successful CTO-PCI has not been investigated so far. In this retrospective registry we seek to describe characteristics and predictors of occurrence of post-procedural ventricular tachycardias.

Methods and results

Between 2010 and 2015, 485 patients underwent successful CTO-PCI at Heart Center Leipzig. Of them, 342 had complete follow-up and were further analyzed. Ventricular tachycardias were detected in 9 (2.6%) patients. All of them were monomorphic ventricular tachycardias occurring in median 1 day (interquartile range [IQR] 0.25–4.75 days) after PCI and caused prolongation of the hospital stay. Patients with ventricular tachycardia were older, had worse left ventricular ejection fraction (mean 33.1%, SD 5.9%) and more frequently a CTO of an infarct-related artery. The target vessel was not associated with the occurrence of ventricular arrhythmias. In multivariable analysis, only impaired left ventricular systolic function was an independent predictor for procedure-related ventricular tachycardia. Mortality rates were not different between patients with or without ventricular tachycardia.

Conclusion

Ventricular tachycardia can occur early after CTO-PCI as possible reperfusion arrhythmia and poorer left ventricular ejection fraction is the only independent predictor for onset. Although the occurrence of ventricular tachycardia after CTO-PCI seems not to influence mortality, awareness of this possible complication and longer monitoring may be recommended.

Klíčová slova:

Arrhythmia – Coronary arteries – Coronary heart disease – Death rates – Ischemia – Medical risk factors – Myocardial infarction – Tachycardia


Zdroje

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2019 Číslo 11