Coronary disease & ACSResearch article
Ischemia modulation via coronary revascularization and effects on the arrhythmic substrate
- Patients were enrolled if they had a left ventricular (LV) ejection fraction (LV ejection fraction (LVEF)) ≤40%, extensive coronary disease
Authors' conclusion
Arrhythmic substrate correlated with scar burden and was unaltered by revascularization in this cohort. There was marked heterogeneity in residual ischemia which correlated with residual arrhythmic substrate. Further work is needed to personalize risk stratification in relation to ischemia reduction and residual arrhythmic risk.
Study context
- Population
- Patients with ischemic LV dysfunction (LVEF ≤40%, extensive coronary disease with British Cardiovascular Intervention Society jeopardy score >6/12) scheduled to undergo percutaneous coronary intervention or coronary artery bypass surgerycoronary artery bypass surgery 12 · percutaneous coronary intervention 18
- Participants
- 30 patients
- Comparison
- 3 months after revascularization vs before
- coronary artery bypass surgeryn = 12
- percutaneous coronary interventionn = 18
- Outcome
- Change in LV ARI dispersion
- Follow-up
- 3 months after revascularization
Main finding
As reported in the abstract
- Mean LV activation recovery interval (ARI) dispersion was unchanged
Further findings
LVEF · Following revascularization
- LVEF increased
- +8 ± 8%
Ischemic burden · Following revascularization
- ischemic burden reduced
- −34 ± 24%
- P < .01
Scar burden · Following revascularization
- scar burden was unchanged
Correlation of individual changes in LV ARI dispersion with individual changes in ischemic burden
- r
- 0.51
- P < .01
Predictors of improvement
- LV volumes and scar burden at baseline and change in indexed LV end-systolic volume and ischemia predicted improvement
Original publication
Ischemia modulation via coronary revascularization and effects on the arrhythmic substrate. Heart Rhythm. Published 28 January 2026. doi:10.1016/j.hrthm.2026.01.031
Summarised from the published abstract; every number is checked against it