Korean Circ J.  2009 Mar;39(3):111-115. 10.4070/kcj.2009.39.3.111.

Clinical, Electrocardiographic, and Procedural Characteristics of Patients With Coronary Chronic Total Occlusions

• Park CS
• Kim HY
• Park HJ
• Ihm SH
• Kim DB
• Lee JM
• Kim PJ
• Park CS
• Moon KW
• Yoo KD
• Jeon DS
• Chung WS
• Seung KB
• Kim JH

• KMID: 1825968
• DOI: http://doi.org/10.4070/kcj.2009.39.3.111

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.

Keyword

Coronary occlusion; Angioplasty; Electrocardiogram

MeSH Terms

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

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