Importance of Dual Induction Tests for Coronary Vasospasm and Ventricular Fibrillation in Patients Surviving Out-of-Hospital Cardiac Arrest

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Background: The pathogenesis of out-of-hospital cardiac arrest (OHCA) without organic heart disease has not been fully investigated. Methods and Results: Induction tests were performed in 12 consecutive patients with OHCA for both coronary vasospasm with intracoronary acetylcholine and ventricular fibrillation (VF) with programmed stimulation at 1 month after the event. All patients were positive for 1 of the tests: coronary vasospasm alone in 3, VF alone in 2, and both in 7. All patients underwent implantable cardioverter defibrillator (ICD) implantation and appropriate ICD shock was documented in 1 patient. Conclusions: OHCA has a heterogeneous pathogenesis and so dual induction tests are necessary. (Circ J 2009; 73: 767 - 769)