What is the clinical evidence from this study?

Study design: Case Report. Population: Resistant vasospastic angina (n=1). Intervention: Cardiac sympathetic denervation. Primary outcome: Clinical stabilization and freedom from anginal or ischemic events.

What does this research mean for the field?

Cardiac sympathetic denervation provides marked clinical stabilization and eliminates ischemic events in severe, medically refractory vasospastic angina, despite persistent angiographic vasoreactivity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the therapeutic efficacy of cardiac sympathetic denervation in a patient with severe vasospastic angina refractory to maximal multi-drug medical therapy.

September 15, 2026European Heart Journal Supplements

Cardiac sympathetic denervation eliminates ischemic events in a patient with refractory vasospastic angina.

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Why the study?

Severe refractory vasospastic angina causing recurrent ischemia and conduction disturbances is challenging to treat and may not respond to standard therapies.

Does cardiac sympathetic denervation prevent ischemic events in a patient with refractory vasospastic angina?

Population

1 patient with severe refractory vasospastic angina and recurrent MINOCA

Comparison

Cardiac sympathetic denervation after maximal medical therapy

Design

Case report

Key result

Cardiac sympathetic denervation resulted in marked clinical stabilization and complete freedom from ischemic events in a patient with refractory vasospastic angina.

Authors

FAF Aliberti MMM Maltempi SSS Sforna

Discussion

Member takes

Overview

Refractory vasospastic MINOCA may need tailored therapy beyond standard agents; hypothesis-generating and requires prospective validation before practice change.

Key Points

To describe the therapeutic efficacy of cardiac sympathetic denervation in a patient with severe vasospastic angina refractory to maximal multi-drug medical therapy.
Clinical and invasive evaluation of a 55-year-old male with recurrent MINOCA and complete atrioventricular block caused by severe coronary vasospasm.
Provocative acetylcholine testing and coronary microvascular function assessments were performed before and after escalating medical therapy with multiple calcium-channel blockers, nitrates, and ranolazine.
Following treatment failure, cardiac sympathetic denervation was performed with physiological reassessment and clinical follow-up through September 2025.
Intracoronary acetylcholine testing at 50 µg repeatedly confirmed epicardial vasospasm with preserved microvascular function and subsequent circumflex artery spasm causing complete heart block.
Following cardiac sympathetic denervation, the patient achieved complete freedom from anginal episodes and recurrent ischemia over eight months of follow-up.
Post-procedure invasive testing demonstrated normal microvascular indices alongside persistent angiographic vasoreactivity to acetylcholine challenge.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does cardiac sympathetic denervation prevent ischemic events in a patient with refractory vasospastic angina?

Population

A 55-year-old man with severe refractory vasospastic angina and recurrent MINOCA treated with cardiac sympathetic denervation.

Intervention

Cardiac sympathetic denervation

Outcome

Clinical stabilization and freedom from anginal or ischemic eventshard clinical

Cardiac sympathetic denervation may be a valuable therapeutic option for severe refractory vasospastic angina unresponsive to maximal medical therapy.

Cite This Study

Aliberti et al. (2026) conducted a case report in Resistant vasospastic angina (n=1). Cardiac sympathetic denervation was evaluated on Clinical stabilization and freedom from anginal or ischemic events. Cardiac sympathetic denervation resulted in marked clinical stabilization and complete freedom from ischemic events in a patient with refractory vasospastic angina.

synapsesocial.com/papers/6aa9016aeed42882c1fc1845 https://doi.org/10.1093/eurheartjsupp/suag058.256

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September 15, 2026European Heart Journal Supplements

Cardiac sympathetic denervation eliminates ischemic events in a patient with refractory vasospastic angina.

View Full Paper

Ask AI

Bookmark

Why the study?

Severe refractory vasospastic angina causing recurrent ischemia and conduction disturbances is challenging to treat and may not respond to standard therapies.

Does cardiac sympathetic denervation prevent ischemic events in a patient with refractory vasospastic angina?

Population

1 patient with severe refractory vasospastic angina and recurrent MINOCA

Comparison

Cardiac sympathetic denervation after maximal medical therapy

Design

Case report

Key result

Cardiac sympathetic denervation resulted in marked clinical stabilization and complete freedom from ischemic events in a patient with refractory vasospastic angina.

Authors

FAF Aliberti MMM Maltempi SSS Sforna

Discussion

Member takes

Overview

Refractory vasospastic MINOCA may need tailored therapy beyond standard agents; hypothesis-generating and requires prospective validation before practice change.

Key Points

To describe the therapeutic efficacy of cardiac sympathetic denervation in a patient with severe vasospastic angina refractory to maximal multi-drug medical therapy.
Clinical and invasive evaluation of a 55-year-old male with recurrent MINOCA and complete atrioventricular block caused by severe coronary vasospasm.
Provocative acetylcholine testing and coronary microvascular function assessments were performed before and after escalating medical therapy with multiple calcium-channel blockers, nitrates, and ranolazine.
Following treatment failure, cardiac sympathetic denervation was performed with physiological reassessment and clinical follow-up through September 2025.
Intracoronary acetylcholine testing at 50 µg repeatedly confirmed epicardial vasospasm with preserved microvascular function and subsequent circumflex artery spasm causing complete heart block.
Following cardiac sympathetic denervation, the patient achieved complete freedom from anginal episodes and recurrent ischemia over eight months of follow-up.
Post-procedure invasive testing demonstrated normal microvascular indices alongside persistent angiographic vasoreactivity to acetylcholine challenge.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does cardiac sympathetic denervation prevent ischemic events in a patient with refractory vasospastic angina?

Population

A 55-year-old man with severe refractory vasospastic angina and recurrent MINOCA treated with cardiac sympathetic denervation.

Intervention

Cardiac sympathetic denervation

Outcome

Clinical stabilization and freedom from anginal or ischemic eventshard clinical

Cardiac sympathetic denervation may be a valuable therapeutic option for severe refractory vasospastic angina unresponsive to maximal medical therapy.

Cite This Study

synapsesocial.com/papers/6aa9016aeed42882c1fc1845 https://doi.org/10.1093/eurheartjsupp/suag058.256

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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