220 MANAGING CARDIAC ARREST SECONDARY TO SPONTANEOUS CORONARY ARTERY DISSECTION: SHOULD WE ROUTINELY CONSIDER ICD IMPLANTATION?

Abstract Introduction Cardiac arrest secondary to a spontaneous coronary artery dissection (SCAD) represents challenging scenario. It deserves specific considerations due the dramatic presentation and need for sudden cardiac death prevention. Methods We collected clinical data of four women admitted during last two years in Coronary Care Unit Parma University Hospital, whose SCAD were ventricular fibrillation. Results Three patients survived acute phases. One patient, being considered at high risk recurrence, received subcutaneous implantable cardioverter-defibrillator (S-ICD). Acute management related considerations. Our case series illustrates importance prompt resuscitation manoeuvres early defibrillation. propose flow chart patient with suspect SCAD. Evaluating recurrence The complicated by malignant arrhythmias is challenging. Looking published registries, it appears that are more likely suffer from arrythmia or than non-SCAD MI patients. risk-benefit ratio ICD implantation these remain uncertain . Evaluation scar burden CMR can help stratify global arrhythmic risk, especially as extensive myocardial residual impaired LVEF increases future events. In our series, only one underwent S-ICD implantation, decision was mainly driven finding underlying arteriopathy affecting other vascular territories, suggesting potentially higher rate recurrence. For this particular subset patients, we an algorithm combines predisposing factors myocardia injury quantification could be useful estimate arrythmias, well SCAD, but needs validated larger studies. Conclusions consideration. damage, precipitants should evaluated order risks.