Cardiac rhythm disorders complicating coronary arterial spasm

Practically every known form of arrhythmia may complicate vasospastic ischemia. Of special importance are sinus node arrest and ventricular fibrillation. The high incidence of arrhythmia in this syndrome may be related to the usually severe profound ischemia or to the sudden massive reperfusion; both can frequently characterize transient severe segmental spasm of an artery without pre-existing stenosis. Nitrates and calcium channel blockers may be effective in the control of vasospasm-induced arrhythmia, but other traditional antiarrhythmic agents and pacemaker treatment may be required in some patients.