{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:27:11Z","timestamp":1782890831505,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coronary spastic angina (CSA) sometimes complicates ventricular arrhythmias (VAs) leading to sudden death. The appropriate secondary prevention strategy remains to be discussed. Recently, the relationship between J waves and VAs in CSA has been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to investigate the incidence of VAs, J waves, the spatial relationship between J waves and culprit coronary spasm lesions, and VA recurrences in CSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patient characteristics, including the presence of J waves, were assessed in 130 CSA patients, and the spatial relationship between J waves and ischemic lesions was analyzed; a concordant pattern was defined when the localization of electrical and coronary blood supply abnormalities matched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty one patients (24%) had VAs (VA group) and 99 (76%) did not (non\u2010VA group). More J waves were observed in the VA group than the non\u2010VA group (19 of 31 patients [61%] vs. 16 of 99 patients [16%], <jats:italic>p<\/jats:italic> = 0.00003). A concordant pattern between the J waves and culprit coronary spasm lesions was significantly observed greater in the VA group than the non\u2010VA group (14 of 19 patients [74%] vs. 5 of 16 patients [31%], <jats:italic>p<\/jats:italic> = 0.019). VAs reoccurred in 6 of 31 patients (19%) despite adequate medication during a mean of 4.6 years of follow\u2010up and were not predictable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VAs occurred in one\u2010quarter of the CSA patients and were closely related to J waves. The spatial concordance between coronary ischemia and electrical abnormalities might be a risk of a VA occurrence. VA recurrences are highly observed and unpredictable, justifying the indication of an implantable cardioverter defibrillator as secondary prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15194","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T12:53:59Z","timestamp":1746881639000},"page":"623-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Indication of Implantable Cardioverter Defibrillators for Ventricular Arrhythmias in Coronary Spastic Angina"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4177-8757","authenticated-orcid":false,"given":"Kenichi","family":"Tani","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine Hyogo 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