Coronary Artery Spasm Recommendations for Patients With Coronary Artery Spasm References that support the recommendations are summarized in Online Data Supplement 20. COR LOE Recommendations I B-NR In patients with VA due to coronary artery spasm, treatment with maximally tolerated doses of a calcium channel blocker and smoking cessation are indicated to reduce recurrent ischemia and VA.S7.1.1.1-1,S7.1.1.1-2 IIa B-NR In patients resuscitated from SCA due to coronary artery spasm in whom medical therapy is ineffective or not tolerated, an ICD is reasonable if meaningful survival of greater than 1 year is expected.S7.1.1.1-3 S7.1.1.1-6 IIb B-NR In patients resuscitated from SCA due to coronary artery spasm, an ICD in addition to medical therapy may be reasonable if meaningful survival of greater than 1 year is Figure 3. Secondary prevention patients with ischemic heart disease. Colors correspond to Class of Recommendation in Table 1. See Sections 4.3.1 and 7.1.1 for discussion. *Exclude reversible causes. History consistent with an arrhythmic etiology for syncope. ICD candidacy as determined by functional status, life expectancy, or patient preference. EP indicates elec- trophysiological; GDMT, guideline-directed management and therapy; ICD, implantable cardioverter-defibrillator; IHD, ischemic heart disease; LVEF, left ventricular ejection fraction; pts, patients; SCA, sudden cardiac arrest; SCD, sudden cardiac death; and VT, ventricular tachycardia. CLINICAL STATEMENTS AND GUIDELINES Recommendation-Specific Supportive Text 1. Coronary artery spasm results from vasomotor dysfunction and can occur in the presence or absence of atherosclerotic ischemic heart disease. Vasospasm episodes can lead to VA, syncope, and SCD. Treatment includes risk factor elimina- tion including smoking cessation, and treatment with vasodilators including dihydropyridine cal- cium channel blockers with or without nitrates. A more detailed summary of treatments for coro- nary artery spasm can be found in other guideline 2. 