Effect of coronary revascularization on electrocardiographic parameters in patients with chronic total occlusion.

Abstract

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. 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. 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. Our findings supported the evidence that successful revascularization of CTO could lead to favorable effect on arrhythmia generation and LVEF.