Abstract
Life-threatening ventricular arrhythmias and pulseless electrical activity due to coronary artery spasm may lead to aborted sudden cardiac death (ASCD). Implantable cardioverter-defibrillator (ICD) had been implanted in majority of these patients. In the previous reports, just a quarter of these patients had appropriate ICD shocks during the follow-up periods of 41 ± 28 months. Although sufficient medications including multiple vasodilators were the first line therapy, less medication were frequently observed in patients with ASCD due to coronary artery spasm in the clinic. One-quarter patients with ASCD due to coronary artery spasm after the implantation of ICD had appropriate ICD shocks under the medications during the follow-up periods, whereas the remaining three-quarter patients had no appropriate ICD shocks. If cardiologists performed the sequential spasm provocation tests under the sufficient medications in ASCD patients due to pure coronary spasm as one of option for the ICD implantation, we may classify these ASCD patients for the requirement of ICD implantation to suppress the next life-threatening ventricular arrhythmias in the future.
