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Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling

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 ventri...

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Autores principales: Yamashita, Kennosuke, Igawa, Wataru, Ono, Morio, Kido, Takehiko, Okabe, Toshitaka, Isomura, Naoei, Araki, Hiroshi, Ochiai, Masahiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849561/
https://www.ncbi.nlm.nih.gov/pubmed/30963616
http://dx.doi.org/10.1111/pace.13691
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author Yamashita, Kennosuke
Igawa, Wataru
Ono, Morio
Kido, Takehiko
Okabe, Toshitaka
Isomura, Naoei
Araki, Hiroshi
Ochiai, Masahiko
author_facet Yamashita, Kennosuke
Igawa, Wataru
Ono, Morio
Kido, Takehiko
Okabe, Toshitaka
Isomura, Naoei
Araki, Hiroshi
Ochiai, Masahiko
author_sort Yamashita, Kennosuke
collection PubMed
description 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.
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spelling pubmed-68495612019-11-15 Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling Yamashita, Kennosuke Igawa, Wataru Ono, Morio Kido, Takehiko Okabe, Toshitaka Isomura, Naoei Araki, Hiroshi Ochiai, Masahiko Pacing Clin Electrophysiol Electrophysiology 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. John Wiley and Sons Inc. 2019-04-25 2019-06 /pmc/articles/PMC6849561/ /pubmed/30963616 http://dx.doi.org/10.1111/pace.13691 Text en © 2019 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Electrophysiology
Yamashita, Kennosuke
Igawa, Wataru
Ono, Morio
Kido, Takehiko
Okabe, Toshitaka
Isomura, Naoei
Araki, Hiroshi
Ochiai, Masahiko
Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title_full Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title_fullStr Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title_full_unstemmed Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title_short Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
title_sort impact of recanalization of chronic total occlusion on left ventricular electrical remodeling
topic Electrophysiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849561/
https://www.ncbi.nlm.nih.gov/pubmed/30963616
http://dx.doi.org/10.1111/pace.13691
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