Clinical, electrocardiographic, and procedural characteristics of patients with coronary chronic total occlusions.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Park
Chan Seok
CS
Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kim
Hee-Yeol
HY
Park
Hun-Jun
HJ
Ihm
Sang-Hyun
SH
Kim
Dong-Bin
DB
Lee
Jong-Min
JM
Kim
Pum-Jun
PJ
Park
Chul-Soo
CS
Moon
Keon-Woong
KW
Yoo
Ki-Dong
KD
Jeon
Doo-Soo
DS
Chung
Wook-Seong
WS
Seung
Ki Bae
KB
Kim
Jae-Hyung
JH