ArticleJournal of the American Heart Association2018
Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long-Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter-Defibrillator (the eCTOpy-in-ICD Study).
Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Impact of CTO Revascularization on Sudden Cardiac Death and/or Ventricular Arrhythmias: A Meta-analysis of Observational Studies.Current cardiology reviews · 2026Pooled it
- Impact of preventive substrate catheter ablation on implantable cardioverter-defibrillator interventions in patients with ischaemic cardiomyopathy and infarct-related coronary chronic total occlusion.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Trial
- Association Between Optimal Revascularization for Chronic Total Occlusion and Long-Term Outcomes in Patients With Heart Failure With or Without Type 2 Diabetes.Journal of the American Heart Association · 2026Article
- Prognostic Value of Cadmium-Zinc-Telluride Dedicated Cardiac SPECT Dynamic Myocardial Perfusion Quantitative Imaging in Patients with Coronary Chronic Total Occlusion: A Pilot Study.Journal of cardiovascular development and disease · 2026Article
- Predictors and Prognostic Significance of Appropriate Implantable Cardioverter-Defibrillator Therapy in Primary Prevention Patients with Ischemic Cardiomyopathy.Journal of clinical medicine · 2026Article
- Impact of CTO-related myocardial infarction and procedural success on long-term outcomes after CTO PCI.Frontiers in cardiovascular medicine · 2026Article
- Impact of a Chronic Total Coronary Occlusion on the Incidence of Appropriate Implantable Cardioverter-Defibrillator Shocks and Mortality: A Substudy of the Dutch Outcome in ICD Therapy (DO-IT)) Registry.Journal of the American Heart Association · 2024Article
- Non-revascularized chronic total occlusions impact on substrate and post-ablation results in drug-refractory electrical storm.Frontiers in cardiovascular medicine · 2023Article
- Tp-e/QTc ratio, SYNTAX, and GRACE score in patients who underwent coronary angiography owing to acute coronary syndrome.Anatolian journal of cardiology · 2021Article
- Infarct-related chronic total coronary occlusion and the risk of ventricular tachyarrhythmic events in out-of-hospital cardiac arrest survivors.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2021Article
- Role of Percutaneous Chronic Total Occlusion Interventions in Patients with Ischemic Cardiomyopathy and Reduced Left Ventricular Ejection Fraction.Current cardiology reports · 2018Review
- PCI in Patients With Heart Failure: Current Evidence, Impact of Complete Revascularization, and Contemporary Techniques to Improve Outcomes.Journal of the Society for Cardiovascular Angiography & InterventionsReview
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies report conflicting results about a higher incidence of ventricular arrhythmias in patients with a chronic total coronary occlusion (CTO). We aimed to investigate this association in a large cohort of implantable cardioverter defibrillator patients with long-term follow-up. METHODS AND
resultsAll consecutive patients from 1992 onwards who underwent implantable cardioverter defibrillator implantation for ischemic cardiomyopathy at the Leiden University Medical Center were evaluated. Coronary angiograms were reviewed for the presence of a CTO. The occurrence of ventricular arrhythmias and survival status at follow-up were compared between patients with and patients without a CTO. A total of 722 patients constitute the study cohort (age 66±11 years; 84% males; 74% primary prevention, median left ventricular ejection fraction 30% [first-third quartile: 25-37], 44% received a cardiac resynchronization therapy defibrillator). At baseline, 240 patients (33%) had a CTO, and the CTOs were present for at least 44 (2-127) months. The median follow-up duration was 4 (2-6) years. On long-term follow-up, CTO patients had a higher crude appropriate device therapy rate (37% versus 27%,
conclusionsThe presence of a CTO in implantable cardioverter defibrillator patients was associated with more appropriate device therapy and worse prognosis at long-term follow-up. Further investigation is warranted regarding a potential beneficial effect of CTO revascularization on the incidence of ventricular arrhythmias.
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