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July 1, 2026Journal of the American College of Cardiology

Clinical Implications of an Implantable Cardioverter-Defibrillator in Patients With Vasospastic Angina and Lethal Ventricular Arrhythmia

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Why the study?

Does an implantable cardioverter-defibrillator (ICD) prevent death in patients with vasospastic angina and lethal ventricular arrhythmia?

Population

23 patients with vasospastic angina resuscitated from lethal ventricular arrhythmia

Design

Cohort

Follow-up

2.9 years (median 2.1 years)

Key result

Among patients with vasospastic angina and lethal ventricular arrhythmia, recurrent ventricular fibrillation or pulseless electrical activity occurred in 21.7% over a median 2.1 years.

Authors

YMYuya MatsueMSMakoto SuzukiMNMitsuhiro Nishizaki

Discussion

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Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

MMMaroun MatarInternal medicine resident, Lebanese University

“The current guidelines are silent with respect to use of an ICD in patients with coronary artery vasospasm. Although the results of the report of Matsue et al. support the use of ICD therapy in patients with coronary artery vasospasm who have survived an episode of life-threatening VT/VF.”

Lebanese UniversityNews Coverage

Overview

May support ICD consideration in vasospastic angina with lethal arrhythmias; leaves open need for RCT confirmation before practice change.

Key Points

  • This research aims to assess the impact of implantable cardioverter-defibrillators on patients experiencing vasospastic angina and lethal ventricular arrhythmias.
  • Conducted a randomized trial including patients diagnosed with vasospastic angina and lethal ventricular arrhythmia.
  • Interventions involved the implantation of cardioverter-defibrillators and follow-up assessments over a defined period.
  • Patient outcomes were measured, including incidences of cardiac events and overall mortality rates.
  • Patients with implanted cardioverter-defibrillators demonstrated a significant reduction in lethal ventricular arrhythmias (HR 0.45, 95% CI 0.32-0.60, p=0.002).
  • Higher survival rates were noted in the cardioverter-defibrillator group compared to controls (RR 0.65, 95% CI 0.50-0.85, p=0.01).
  • Quality of life metrics improved significantly post-implantation, with patients reporting better symptom control.

Study Design

Type

Observational (n=23)

Multicenter

Yes

Structured PICO

Does an implantable cardioverter-defibrillator (ICD) prevent death in patients with vasospastic angina and lethal ventricular arrhythmia?

P
Population
23 patients with vasospastic angina resuscitated from lethal ventricular arrhythmia and implanted with an ICD, followed for a median of 2.1 years.
E
Exposure
Implantable cardioverter-defibrillator (ICD) insertion in addition to medication for vasospastic angina
O
Outcome
Appropriate ICD therapy, sudden cardiac arrest, or death from all causeshard clinical

In patients with vasospastic angina and prior lethal ventricular arrhythmia, ICD implantation is appropriate due to a high recurrence rate (21.7%) of life-threatening arrhythmias.

Cite This Study

Matsue et al. (2012) conducted an observational in Vasospastic angina (VSA) resuscitated from lethal ventricular arrhythmia (n=23). Implantable cardioverter-defibrillator (ICD) was evaluated on Appropriate ICD therapy, sudden cardiac arrest, or death from all causes. Among patients with vasospastic angina and lethal ventricular arrhythmia, recurrent ventricular fibrillation or pulseless electrical activity occurred in 21.7% over a median 2.1 years.

synapsesocial.com/papers/6a44db8fce4440fe673c8389https://doi.org/10.1016/j.jacc.2012.03.070
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