Clinical, Electrocardiographic, and Procedural Characteristics of Patients With Coronary Chronic Total Occlusions.
10.4070/kcj.2009.39.3.111
- Author:
Chan Seok PARK
1
;
Hee Yeol KIM
;
Hun Jun PARK
;
Sang Hyun IHM
;
Dong Bin KIM
;
Jong Min LEE
;
Pum Jun KIM
;
Chul Soo PARK
;
Keon Woong MOON
;
Ki Dong YOO
;
Doo Soo JEON
;
Wook Seong CHUNG
;
Ki Bae SEUNG
;
Jae Hyung KIM
Author Information
1. Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. cumckhy@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Coronary occlusion;
Angioplasty;
Electrocardiogram
- MeSH:
Angioplasty;
Bundle-Branch Block;
Coronary Angiography;
Coronary Occlusion;
Electrocardiography;
Hospitals, University;
Humans;
Internet;
No-Reflow Phenomenon;
Percutaneous Coronary Intervention;
Stents;
Stroke Volume;
Ventricular Function, Left
- From:Korean Circulation Journal
2009;39(3):111-115
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Percutaneous coronary intervention for chronic total occlusion lesions is technically difficult despite equipment advances. Changes in electrocardiographic patterns, such as Q and T waves, during chronic total occlusion can provide information about procedural success and myocardial viability. In this study, we investigated clinical, electrocardiographic, and procedural characteristics of chronic total occlusions. SUBJECTS AND METHODS: Patients (2,635) who underwent coronary angiography between January 2006 and July 2007 at six Catholic University Hospitals were identified using a dedicated Internet database. RESULTS: A total of 195 patients had total occlusion lesions (7.4%). Percutaneous coronary interventions were attempted in 136 total occlusion lesions (66.0%) in 134 patients. Successful recanalization with stent implantation was accomplished in 89 lesions, with a procedural success rate of 66.4%. One procedure-related death occurred because of no-reflow phenomenon. After excluding 8 patients with bundle branch block, Q and T wave inversions were observed in 60 (32.1%) and 78 patients (41.7%), respectively. The presence of Q waves was associated with severe angina, decreased left ventricular ejection fraction, regional wall motion abnormality, and T wave inversion, but was not related to procedural success. CONCLUSION: Percutaneous coronary intervention is a safe and useful procedure for the revascularization of coronary chronic total occlusion lesions. The procedural success rate was not related to the presence of pathologic Q waves, which were associated with severe angina and decreased left ventricular function.
