Impact of chronic total occlusion on ventricular arrhythmia and mortality in ischaemic cardiomyopathy patient with implantable cardiac defibrillator: a meta-analysis

Vutthikraivit, Wasawat; Rattanawong, Pattara; Kewcharoen, Jakrin; Kanitsoraphan, Chanavuth; Pachariyanon, Pavida; Suchartlikitwong, Sakolwan; Klomjit, Saranapoom; Tantrachoti, Pakpoom

doi:10.6084/m9.figshare.7218146.v1

tacd_a_1516268_sm3123.docx (22.86 kB)

Impact of chronic total occlusion on ventricular arrhythmia and mortality in ischaemic cardiomyopathy patient with implantable cardiac defibrillator: a meta-analysis

journal contribution

posted on 2018-10-17, 13:46 authored by Wasawat Vutthikraivit, Pattara Rattanawong, Jakrin Kewcharoen, Chanavuth Kanitsoraphan, Pavida Pachariyanon, Sakolwan Suchartlikitwong, Saranapoom Klomjit, Pakpoom Tantrachoti

Background: Recent studies suggested that chronic total occlusion of the coronary artery increased risk of ventricular arrhythmia (VA) and all-cause mortality in ischaemic cardiomyopathy (ICM) patient who underwent implantable cardiac defibrillator (ICD) implantation. We aim to demonstrate an association between a presence of CTO and poor cardiovascular outcome in ICD implanted ICM patients.

Objective: To examine the association between the presence of CTO and all-cause mortality in ICM with ICD implantation

Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to February 2018. The studies that reported appropriated shock and all-cause mortality in ICD implanted ICM patients, compared between patients with and without CTO of the coronary artery, were included for meta-analysis.

Results: Five studies from 2015 to 2018 were included in this meta-analysis involving 1,095 subjects (505 CTO and 590 non-CTO). The presence of CTO was associated with increased incidence of VA (pooled risk ratio = 1.75, 95% confidence interval: 1.10-2.77, p = 0.01) and all-cause mortality (pooled risk ratio = 1.63, 95% confidence interval: 1.10-2.41, p = 0.001) in ICD implanted ICM patients.

Conclusions: Presence of CTO of the coronary artery increased risk of VA and all-cause mortality in ICD implanted ICM patients up to 75% and 63%, respectively. Our study suggested that CTO is an independent predictor of unfavourable outcome and revascularised option should be considered in ICM patients with ICD.