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Updated: Jun 16, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

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Indication of Implantable Cardioverter Defibrillators for Ventricular Arrhythmias in Coronary Spastic Angina

Kenichi Tani1, Mitsuru Takami1, Kimitake Imamura1,2

  • 1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan.

Pacing and Clinical Electrophysiology : PACE
|May 10, 2025
PubMed

Insights

Ventricular arrhythmias (VAs) in coronary spastic angina (CSA) are linked to J waves and spatial concordance between ischemia and electrical abnormalities. VA recurrences are unpredictable, suggesting implantable cardioverter-defibrillators for secondary prevention.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Coronary spastic angina (CSA) can lead to sudden death due to ventricular arrhythmias (VAs).
  • Secondary prevention strategies for VAs in CSA require further investigation.
  • Recent studies suggest a link between J waves and VAs in CSA patients.

Purpose of the Study:

  • To determine the incidence of VAs and J waves in CSA patients.
  • To analyze the spatial relationship between J waves and coronary spasm lesions.
  • To assess the recurrence rate of VAs in CSA.

Main Methods:

  • 130 CSA patients were evaluated for VAs and J waves.
  • Spatial concordance between J waves and ischemic lesions was analyzed.
  • Concordant pattern defined by matching electrical and coronary blood supply abnormalities.

Main Results:

  • VAs occurred in 24% of CSA patients; J waves were more prevalent in the VA group (61% vs. 16%).
  • Spatial concordance between J waves and coronary spasm lesions was significantly higher in the VA group (74% vs. 31%).
  • 19% of patients experienced VA recurrence despite medication, with unpredictable outcomes.

Conclusions:

  • VAs in CSA are associated with J waves and spatial concordance of electrical and ischemic abnormalities.
  • The spatial concordance may indicate a risk factor for VA occurrence.
  • High and unpredictable VA recurrence rates support implantable cardioverter-defibrillators for secondary prevention in CSA.
Abstract

Keywords:
Brugada syndromeJ wavecoronary spastic anginaearly repolarization syndromeimplantable cardioverter defibrillatorventricular arrhythmias

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