Chronic total occulusion (CTO) has been identified as an independent predictor of ventricular arrhythmias in the VACTO Primary Study [Nombela-Franco L et al. Ventricular Arrhythmias Among Implantable Cardioverter Defibrillator Recipients for Primary Prevention: Impact of Chronic Total Coronary Occlusion (VACTO Primary Study). CIRCEP.111.968008 Published online before print December 28, 2011,
doi: 10.1161/?CIRCEP.111.968008]. They included all consecutive patients receiving implantable cardioverter defibrillators (ICD) for coronary artery disease and identified seventy one patients out of a total of one hundred and sixty two patients as having at least one chronic total occlusion. The presence of CTO was associated with higher rates of ventricular arrhythmia requiring ICD therapy and higher mortality with a log-rank <0.01. Chronic total occlusion was also independently associated with appropriate ICD intervention on multivariate analysis with a hazard ratio of 3.5 (p=0.003).
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