Abstract
ObjectivesThis study sought to investigate the prevalence of ventricular tachycardia after percutaneous coronary intervention (PCI) of chronic total occlusion (CTO).BackgroundPCI 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 resultsBetween 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.ConclusionVentricular 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.
Highlights
Percutaneous coronary intervention (PCI) for revascularization of a chronic total occlusion (CTO) is a challenging procedure
PCI of a CTO is associated with improvement of the left ventricular ejection fraction and possibly associated with reduced mortality
Whereas the rates of the most common Major adverse cardiac events (MACE) such as acute myocardial infarction, cardiac tamponade or coronary vessel perforation were described in detail, until recently, no cases of ventricular arrhythmia due to revascularization of a CTO were reported.[13, 16]
Summary
Percutaneous coronary intervention (PCI) for revascularization of a chronic total occlusion (CTO) is a challenging procedure. In this retrospective registry we seek to describe characteristics and predictors of occurrence of postprocedural ventricular tachycardias
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