- 作者：Yuya Matsue ; Makoto Suzuki ; Mitsuhiro Nishizaki ; Rintaro Hojo ; Yuji Hashimoto ; Harumizu Sakurada
- 关键词：implantable cardioverter-defibrillator ; vasospastic angina ; ventricular arrhythmia
- 刊名：Journal of the American College of Cardiology
- 出版年：2012
- 出版时间：4 September, 2012
- 年：2012
- 卷：60
- 期：10
- 页码：908-913
- 全文大小：1174 K
Objectives
The present study was performed to investigate the clinical implications of an implantable cardioverter-defibrillator (ICD) in patients with vasospastic angina (VSA) resuscitated from lethal ventricular arrhythmia.Background
The prognosis of VSA is known to be good with medication; however, ventricular arrhythmia and cardiopulmonary arrest are rare but life-threatening complications of this disease. The ICD is a proven modality for patients with ventricular arrhythmia, but the clinical implications in this population remain to be elucidated.
Methods
We conducted a retrospective, observational, multicenter study involving patients with an ICD due to documented ventricular arrhythmia and VSA diagnosed by acetylcholine provocation test. All patients were followed up for appropriate ICD therapy, sudden cardiac arrest, or death from all causes.
Results
Twenty-three patients were included in the present study and completely followed up. All patients are still alive. During a follow-up of 2.9 years (median 2.1 years), 4 ventricular fibrillations and 1 episode of pulseless electrical activity occurred in 5 patients (21.7 % ). There were no statistically significant differences in patient characteristics between the recurrence and nonrecurrence groups, including medication, smoking status, and whether the patient was or was not free of symptoms after ICD implantation.
Conclusions
Patients with VSA and lethal ventricular arrhythmia are a population at high risk for recurrence of cardiopulmonary arrest, and there is no reliable indicator for predicting recurrence of ventricular arrhythmia. Insertion of an ICD with medication for VSA is appropriate for this high-risk population.