1080-42 Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions

Abstract

Hypothesis:The 12-lead-resting electrocardiogram (ECG) is a predictor of LV recovery after successful recanalization of CTO. Methods:Successful recanalization of CTO was performed in 127 patients. Of these, 62 patients, who constitute the study group, had impaired regional wall motion prior to recanalization. The 12-lead resting ECG was evaluated for Q-wave areas and parameters of QT dispersion. Impairment of regional wall motion was evaluated by LV angiogram at baseline and at follow-up. Results: Angiographic follow-up after 5 ± 1.4 months documented reocclusion in eight patients. Complete follow-up with a patent coronary artery and an ECG without bundlebranch block was available in 43 patients. Wall motion severity index (WMSI) improved from � 2.92 ± 0.28 to � 1.34 ± 0.61 (p < 0.001) in patients without Q waves, whereas it was unchanged in patients with Q waves (� 3.01 ± 0.30 and � 2.81 ± 0.32). Absence of Q waves at baseline predicted recovery of regional wall motion with 89% sensitivity and 67% specificity. Positive predictive value for recovery was 68% in patients without Q waves, but only 11% in patients with Q waves. In multivariate analysis, only absence of Q waves predicted improvement in WMSI (p = 0.01). Conclusions:In patients with recanalization of CTO, recovery of regional wall motion is reliably predicted by analysis of the resting 12-lead ECG for pathologic Q waves.