ICD therapy feasible in vasospastic angina after resuscitation

Using implantable cardioverter defibrillator (ICD) as a secondary prophylaxis is feasible in patients resuscitated from sudden cardiac arrest (SCA), leading to similar long-term outcomes in those with vasospastic angina (VSA) or other cardiac diseases, a recent study has found.

The study included 280 patients who had been resuscitated from SCA and were given an ICD for secondary prophylaxis. The primary endpoint of interest was a composite of all-cause death and receipt of appropriate ICD therapy, defined as anti-tachycardia pacing and shock.

Of the patients, 51 (18 percent) had VSA, while the rest had cardiac diseases of other aetiologies, including ischaemic cardiomyopathy, which was the principal cause of SCA in 38 percent of patients. Other common aetiologies included nonischaemic cardiomyopathies (18 percent) and Brugada syndrome (7 percent).

Over a median follow-up of 3.8 years, 23 patients died and 72 received appropriate ICD therapies, yielding corresponding rates of 8 percent and 26 percent.

The incidence of the primary endpoint did not differ between those with VSA and those with other cardiac aetiologies (24 percent vs 33 percent; p=0.19), pointing to the potential of ICD implantation in a broad range of SCA aetiologies, the researchers said.

“To the best of our knowledge, this is the largest report to have investigated the prognosis of patients with VSA who received ICD implantation as secondary prophylaxis,” they added.