Difference Of Clinical Characteristics Of Sudden Cardiac Arrest And Syncope Related To Coronary Vasospasm

Patients with coronary vasospasm generally have a good prognosis although lethal arrhythmia can result in sudden cardiac arrest (SCA) or syncope. Clinical predictors of SCA related to coronary vasospasm were not clear. We investigated the differences of clinical characteristics and outcome of pts with SCA and syncope related to coronary vasospasm. Method and results; Out of consecutive 47 pts with coronary vasospasm, pts presented SCA(n=13) and syncope(n=26) were enrolled in the study. Pts complicated with 5 idiopathic VF/VT and 3 neurally-mediated syncope were excluded. All pts had a normal LV function except 1 pt with ACS. One pt had coronary artery disease. SCA was experienced during first cardiac event in 77% of SCA group, whereas syncope in 31% of syncope group (p=0.04, as shown in Table ). In SCA group, 2 pts resulted in hospital death after DC-resistant VF, 1 pt died suddenly at home after medical-refractory angina. ICD was implanted in 3 survivors. Ca channel blockers were administered in all pts of each group. After discharge of hospital, during a follow-up period of 3.7±4.1yrs, survivors of SCA group did not experience any additional arrhythmic events and all pts of syncope group were alive while 1 pt had recurrent syncope. Conclusion; Coronary vasospasm can results in SCA during a first cardiac event. The prognosis of the survivors and pts with a history of syncope may be favorable under good medical control of spasm.