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Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
Author(s) -
Yamashita Kennosuke,
Igawa Wataru,
Ono Morio,
Kido Takehiko,
Okabe Toshitaka,
Isomura Naoei,
Araki Hiroshi,
Ochiai Masahiko
Publication year - 2019
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13691
Subject(s) - medicine , conventional pci , cardiology , endocardium , sinus rhythm , percutaneous coronary intervention , coronary sinus , ventricular remodeling , occlusion , myocardial infarction , atrial fibrillation
Background Successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is associated with reduction of cardiac mortality, as well as reducing fatal ventricular arrhythmias. The aim of this study was to evaluate the effect of recanalization of CTO on endocardial left ventricular voltages by paired electrophysiological studies. Methods Sixteen consecutive patients who underwent PCI for de novo CTO lesions were included. High‐density mapping was performed during sinus rhythm before and 8 months after PCI. According to the amplitude of bipolar electrograms, the left ventricular endocardium was classified into a preserved normal voltage (>1.5 mV), border zone (0.5–1.5 mV), and dense scar areas (<0.5 mV). Results The border zone area had a significant positive correlation with CTO length, as well as a significant negative correlation observed in the preserved voltage region. In the successful PCI patient, the median dense scar area did not change significantly (reported as [median difference: 95% confidence interval]) between baseline and after PCI (0.1 cm 2 : –2.8 to 2.9). However, the area of the border zone decreased (–10.5 cm 2 : –16.8 to –4.1) and the preserved voltage area increased significantly (19.2 cm 2 : 7.7–30.6). In addition, successful PCI was related to slight, but significant, increase in the amplitude of unipolar and bipolar voltage (1.55 mV: 0.88–3.33, 0.23 mV: 0.08–0.36). Conclusions Recanalization of CTO may promote reverse electrical remodeling in the border zone of the left ventricle, without affecting the dense scar tissue.