RT Journal Article
T1 Long-term prognosis of patients with life-threatening ventricular arrhythmias induced by coronary artery spasm.
A1 Rodríguez-Mañero, Moisés
A1 Oloriz, Teresa
A1 le Polain de Waroux, Jean-Benoit
A1 Burri, Haran
A1 Kreidieh, Bahij
A1 de Asmundis, Carlos
A1 Arias, Miguel A
A1 Arbelo, Elena
A1 Díaz Fernández, Brais
A1 Fernández-Armenta, Juan
A1 Basterra, Nuria
A1 Izquierdo, María Teresa
A1 Díaz-Infante, Ernesto
A1 Ballesteros, Gabriel
A1 Carrillo López, Andrés
A1 García-Bolao, Ignacio
A1 Benezet-Mazuecos, Juan
A1 Expósito-García, Victor
A1 Larraitz-Gaztañaga, 
A1 Martínez-Sande, Jose Luis
A1 García-Seara, Javier
A1 González-Juanatey, Jose Ramón
A1 Peinado, Rafael
AB Coronary artery spasm (CAS) is associated with ventricular arrhythmias (VA). Much controversy remains regarding the best therapeutic interventions for this specific patient subset. We aimed to evaluate the clinical outcomes of patients with a history of life-threatening VA due to CAS with various medical interventions, as well as the need for ICD placement in the setting of optimal medical therapy. A multicentre European retrospective survey of patients with VA in the setting of CAS was aggregated and relevant clinical and demographic data was analysed. Forty-nine appropriate patients were identified: 43 (87.8%) presented with VF and 6 (12.2%) with rapid VT. ICD implantation was performed in 44 (89.8%). During follow-up [59 (17-117) months], appropriate ICD shocks were documented in 12. In 8/12 (66.6%) no more ICD therapies were recorded after optimizing calcium channel blocker (CCB) therapy. SCD occurred in one patient without ICD. Treatment with beta-blockers was predictive of appropriate device discharge. Conversely, non-dihydropyridine CCB therapy was significantly protective against VAs. Patients with life-threatening VAs secondary to CAS are at particularly high-risk for recurrence, especially when insufficient medical therapy is administered. Non-dihydropyridine CCBs are capable of suppressing episodes, whereas beta-blocker treatment is predictive of VAs. Ultimately, in spite of medical intervention, some patients exhibited arrhythmogenic events in the long-term, suggesting that ICD implantation may still be indicated for all.
YR 2018
FD 2018
LK http://hdl.handle.net/10668/11065
UL http://hdl.handle.net/10668/11065
LA en
DS RISalud
RD Apr 18, 2025