{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:08:27Z","timestamp":1781114907231,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate whether the revascularization of a coronary chronic total occlusion in an infarct\u2010related artery (IRACTO) may be associated with lower recurrence of ventricular arrhythmias (VA) among patients with a secondary prevention implantable cardioverter defibrillator (ICD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>IRACTO is increasingly recognized as an independent predictor of VA. It is unknown whether IRACTO revascularization can reduce the burden of VA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicenter observational cohort study that included consecutive patients with prior myocardial infarction and secondary prevention ICD. The primary endpoint was any appropriate ICD therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 460 patients included, 269 (58%) had at least one IRACTO at the coronary angiogram performed before ICD implantation; of these, 20 (7%) had their IRACTO successfully revascularized (IRACTO\u2010R) afterwards. During a median follow\u2010up of 48\u2009months, 229 patients (49%) had at least one appropriate ICD therapy. Patients with IRACTO not revascularized (IRACTO\u2010NR) had the highest incidence of ICD therapies (65%) while patients with IRACTO\u2010R had the lowest (10%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). In the entire cohort, IRACTO\u2010NR was an independent predictor of appropriate ICD therapies (HR 2.85, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and appropriate ICD shocks (HR 2.94, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Among patients with IRACTO at baseline, IRACTO\u2010R was independently associated with a marked reduction of appropriate ICD therapies (HR 0.12, <jats:italic>p<\/jats:italic> = .002) and appropriate ICD shocks (HR 0.21, <jats:italic>p<\/jats:italic> = .03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with prior myocardial infarction and secondary prevention ICD, IRACTO revascularization was independently associated with a markedly lower incidence of appropriate ICD therapies and shocks. These results should be corroborated by larger prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28915","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T21:07:45Z","timestamp":1590613665000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Revascularization of coronary chronic total occlusions in an infarct\u2010related artery and recurrence of ventricular arrhythmias among patients with secondary prevention implantable cardioverter defibrillator"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-8112","authenticated-orcid":false,"given":"Andrea","family":"Di Marco","sequence":"first","affiliation":[{"name":"Cardiology Department Bellvitge University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignasi","family":"Anguera","sequence":"additional","affiliation":[{"name":"Cardiology 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