Effect of coronary revascularization on electrocardiographic parameters in patients with chronic total occlusion
Postgraduate Medical Journal, vol.101, no.1202, pp.1311-1316, 2025 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 101 Issue: 1202
- Publication Date: 2025
- Doi Number: 10.1093/postmj/qgaf108
- Journal Name: Postgraduate Medical Journal
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Page Numbers: pp.1311-1316
- Keywords: coronary heart disease, coronary intervention, ischemic heart disease
- Istanbul University Affiliated: Yes
Abstract
Purpose Substantial evidence suggests that revascularization of chronic total occlusion (CTO) leads to improvement of quality of life and ventricular function. We studied the effect of revascularization on electrocardiographic parameters in patients with CTO. Study design The data of patients who underwent CTO percutaneous intervention (PCI) were collected. QT dispersion (QTD), P-wave dispersion (PWD), T-wave peak-to-end (Tp - Te) interval, and Tp - Te/QT ratio were calculated for each patient before and 7 days after the intervention. Patients were divided into two groups according to their Rentrop grades. Results One hundred and thirty three patients underwent successful CTO intervention. Their mean age was 61.88 ± 10.53 years, the median left ventricular ejection fraction (LVEF) was 55 (43.00-60.00). After revascularization, P-wave maximum, minimum duration, and PWD were significantly reduced. We found no difference in QRS duration between the pre- and post-PCI periods (P =. 522). Corrected QT interval, QTc maximum, minimum time, and QTDc were all reduced after PCI. Tp - Te interval and Tp - Te/QT ratio were also found to decrease after successful revascularization (P <. 001 for both). LVEF increased from 52.00 (42.75-60.00) to 55.00 (45.00-60.00) (P =. 001). Compared to patients in Rentrop Group 2, patients in Group 1 had increased values for PWD before the procedure and for QTDc before and after the procedure. Multivariable linear regression analysis revealed that age and the SYNTAX score were predictors of the QTDc difference. Conclusions Our findings supported the evidence that successful revascularization of CTO could lead to favorable effect on arrhythmia generation and LVEF. Key messages What is already known on this topic Previous studied have shown that revascularization of chronic total occlusion could result in prognostic benefit in these patients. What this study adds Our results showed that after successful revascularization, electrocardiographic parameters including P-wave dispersion, corrected QT interval, QT dispersion, Tp - Te/QT ratio were all reduced, all of which are favorably associated with arrhythmia occurrence. SYNTAX score and age were the independent predictors for QTDc difference before and after intervention. How this study might affect research, practice, or policy Randomized trials measuring the prognostic value of these parameters in CTO patients may change our clinical practice.