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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: https://doi.org/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

1. Hoebers LP, Claessen BE, Elias J, Dangas GD, Mehran R, Henriques JP. Meta-analysis on the impact of percutaneous coronary intervention of chronic total occlusions on left ventricular function and clinical outcome. International journal of cardiology. 2015;187:90–6. doi: 10.1016/j.ijcard.2015.03.164 25828320.

2. Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis. American heart journal. 2010;160(1):179–87. doi: 10.1016/j.ahj.2010.04.015 20598990.

3. Stone GW, Kandzari DE, Mehran R, Colombo A, Schwartz RS, Bailey S, et al. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I. Circulation. 2005;112(15):2364–72. Epub 2005/10/12. doi: 10.1161/CIRCULATIONAHA.104.481283 16216980.

4. Christofferson RD, Lehmann KG, Martin GV, Every N, Caldwell JH, Kapadia SR. Effect of chronic total coronary occlusion on treatment strategy. The American journal of cardiology. 2005;95(9):1088–91. doi: 10.1016/j.amjcard.2004.12.065 15842978.

5. Fefer P, Knudtson ML, Cheema AN, Galbraith PD, Osherov AB, Yalonetsky S, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. Journal of the American College of Cardiology. 2012;59(11):991–7. doi: 10.1016/j.jacc.2011.12.007 22402070.

6. Jeroudi OM, Alomar ME, Michael TT, El Sabbagh A, Patel VG, Mogabgab O, et al. Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital. Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions. 2014;84(4):637–43.

7. Werner GS, Gitt AK, Zeymer U, Juenger C, Towae F, Wienbergen H, et al. Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice. Clinical research in cardiology: official journal of the German Cardiac Society. 2009;98(7):435–41. doi: 10.1007/s00392-009-0013-5 19294443.

8. Di Marco A, Anguera I, Teruel L, Dallaglio P, Gonzalez-Costello J, Leon V, et al. Chronic total occlusion of an infarct-related artery: a new predictor of ventricular arrhythmias in primary prevention implantable cardioverter defibrillator patients. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2016. doi: 10.1093/europace/euw009 27605524.

9. Nombela-Franco L, Mitroi CD, Fernandez-Lozano I, Garcia-Touchard A, Toquero J, Castro-Urda V, et al. Ventricular arrhythmias among implantable cardioverter-defibrillator recipients for primary prevention: impact of chronic total coronary occlusion (VACTO Primary Study). Circulation Arrhythmia and electrophysiology. 2012;5(1):147–54. doi: 10.1161/CIRCEP.111.968008 22205684.

10. Nombela-Franco L, Iannaccone M, Anguera I, Amat-Santos IJ, Sanchez-Garcia M, Bautista D, et al. Impact of Chronic Total Coronary Occlusion on Recurrence of Ventricular Arrhythmias in Ischemic Secondary Prevention Implantable Cardioverter-Defibrillator Recipients (VACTO Secondary Study): Insights From Coronary Angiogram and Electrogram Analysis. JACC Cardiovascular interventions. 2017;10(9):879–88. doi: 10.1016/j.jcin.2017.02.008 28473110.

11. Brilakis ES, Banerjee S, Karmpaliotis D, Lombardi WL, Tsai TT, Shunk KA, et al. Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry). JACC Cardiovascular interventions. 2015;8(2):245–53. doi: 10.1016/j.jcin.2014.08.014 25700746.

12. El Sabbagh A, Patel VG, Jeroudi OM, Michael TT, Alomar ME, Mogabgab O, et al. Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 3,482 patients from 26 studies. International journal of cardiology. 2014;174(2):243–8. doi: 10.1016/j.ijcard.2014.04.004 24768461.

13. Khan MF, Brilakis ES, Wendel CS, Thai H. Comparison of procedural complications and in-hospital clinical outcomes between patients with successful and failed percutaneous intervention of coronary chronic total occlusions: a meta-analysis of observational studies. Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions. 2015;85(5):781–94.

14. Patel VG, Michael TT, Mogabgab O, Fuh E, Banerjee A, Brayton KM, et al. Clinical, angiographic, and procedural predictors of periprocedural complications during chronic total occlusion percutaneous coronary intervention. The Journal of invasive cardiology. 2014;26(3):100–5. 24610502.

15. Suero JA, Marso SP, Jones PG, Laster SB, Huber KC, Giorgi LV, et al. Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. Journal of the American College of Cardiology. 2001;38(2):409–14. doi: 10.1016/s0735-1097(01)01349-3 11499731.

16. Patel VG, Brayton KM, Tamayo A, Mogabgab O, Michael TT, Lo N, et al. Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies. JACC Cardiovascular interventions. 2013;6(2):128–36. doi: 10.1016/j.jcin.2012.10.011 23352817.

17. Koenig S, Arya A, Hindricks G, Dinov B. Catheter ablation of ventricular tachycardia in the setting of electrical storm after revascularization of a chronic total occlusion of the right coronary artery: An uncommon presentation of reperfusion arrhythmia. HeartRhythm case reports. 2016;2(6):462–4. doi: 10.1016/j.hrcr.2016.04.008 28491737

18. Christopoulos G, Menon RV, Karmpaliotis D, Alaswad K, Lombardi W, Grantham A, et al. The efficacy and safety of the "hybrid" approach to coronary chronic total occlusions: insights from a contemporary multicenter US registry and comparison with prior studies. The Journal of invasive cardiology. 2014;26(9):427–32. 25198485

19. Wilson WM, Walsh SJ, Yan AT, Hanratty CG, Bagnall AJ, Egred M, et al. Hybrid approach improves success of chronic total occlusion angioplasty. Heart. 2016;102(18):1486–93. doi: 10.1136/heartjnl-2015-308891 27164918.

20. Abe M, Morimoto T, Morino Y, Tanaka H, Akao M, Hayashi Y, et al. Association between J-CTO score and long-term target lesion revascularization rate after successful chronic total coronary occlusion angioplasty (from the J-CTO Registry). Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions. 2019;93(6):1025–32. Epub 2019/02/07.

21. Christopoulos G, Wyman RM, Alaswad K, Karmpaliotis D, Lombardi W, Grantham JA, et al. Clinical Utility of the Japan-Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions: Results from a Multicenter Registry. Circ Cardiovasc Interv. 2015;8(7):e002171. Epub 2015/07/15. doi: 10.1161/CIRCINTERVENTIONS.114.002171 26162857

22. Ramunddal T, Hoebers LP, Henriques JP, Dworeck C, Angeras O, Odenstedt J, et al. Chronic total occlusions in Sweden—a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). PloS one. 2014;9(8):e103850. doi: 10.1371/journal.pone.0103850 25117457

23. Ma JY, Qian JY, Ge L, Fan B, Wang QB, Yan Y, et al. Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication. Chinese medical journal. 2013;126(6):1086–91. 23506583.

24. Majidi M, Kosinski AS, Al-Khatib SM, Lemmert ME, Smolders L, van Weert A, et al. Reperfusion ventricular arrhythmia ‘bursts’ in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2008;10(8):988–97. doi: 10.1093/europace/eun123 18483000.

25. Dinov B, Fiedler L, Schonbauer R, Bollmann A, Rolf S, Piorkowski C, et al. Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study. Circulation. 2014;129(7):728–36. Epub 2013/11/12. doi: 10.1161/CIRCULATIONAHA.113.003063 24211823.

26. Jurkovicova O, Cagan S. [Reperfusion arrhythmias]. Bratislavske lekarske listy. 1998;99(3–4):162–71. 9919746.

27. Solhjoo S, O’Rourke B. Mitochondrial instability during regional ischemia-reperfusion underlies arrhythmias in monolayers of cardiomyocytes. Journal of molecular and cellular cardiology. 2015;78:90–9. doi: 10.1016/j.yjmcc.2014.09.024 25268650

28. Xiang S, Zhao H. Interrelationship between magnesium and potassium in preventing myocardial ischemia-reperfusion arrhythmia. Chinese medical journal. 1996;109(4):282–5. 8758288.

29. Canty JM Jr., Suzuki G, Banas MD, Verheyen F, Borgers M, Fallavollita JA. Hibernating myocardium: chronically adapted to ischemia but vulnerable to sudden death. Circulation research. 2004;94(8):1142–9. doi: 10.1161/01.RES.0000125628.57672.CF 15016734.

30. Fernandez SF, Ovchinnikov V, Canty JM Jr., Fallavollita JA. Hibernating myocardium results in partial sympathetic denervation and nerve sprouting. American journal of physiology Heart and circulatory physiology. 2013;304(2):H318–27. doi: 10.1152/ajpheart.00810.2011 23125211

31. Sotomi Y, Okamura A, Iwakura K, Date M, Nagai H, Yamasaki T, et al. Impact of revascularization of coronary chronic total occlusion on left ventricular function and electrical stability: analysis by speckle tracking echocardiography and signal-averaged electrocardiogram. The international journal of cardiovascular imaging. 2017;33(6):815–23. doi: 10.1007/s10554-017-1064-8 28091872.

32. Di Marco A, Paglino G, Oloriz T, Maccabelli G, Baratto F, Vergara P, et al. Impact of a chronic total occlusion in an infarct-related artery on the long-term outcome of ventricular tachycardia ablation. Journal of cardiovascular electrophysiology. 2015;26(5):532–9. doi: 10.1111/jce.12622 25598359.

33. Ilia R, Zahger D, Cafri C, Abu-Ful A, Weinstein JM, Yaroslavtsev S, et al. Predicting survival with reperfusion arrhythmias during primary percutaneous coronary intervention for acute myocardial infarction. The Israel Medical Association journal: IMAJ. 2007;9(1):21–3. 17274350.

34. Majidi M, Kosinski AS, Al-Khatib SM, Smolders L, Cristea E, Lansky AJ, et al. Implications of ventricular arrhythmia "bursts" with normal epicardial flow, myocardial blush, and ST-segment recovery in anterior ST-elevation myocardial infarction reperfusion: a biosignature of direct myocellular injury "downstream of downstream". European heart journal Acute cardiovascular care. 2015;4(1):51–9. doi: 10.1177/2048872614532414 25063574.


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