Background:
Severe refractory angina pectoris can occur in end-stage coronary artery disease despite
maximal medical and revascularization therapy. Spinal cord stimulation is an under-utilized
but well-established modality for the treatment of intractable angina pain.
Aim:
To illustrate the practical, beneficial and effective use of spinal cord stimulation
as a treatment option for refractory angina in a local context.
Method:
A case series clinical audit of 11 patients with refractory angina treated with spinal
cord stimulation over a one-year period was carried out. Baseline, three-month, six-month
and two-year functional assessment data and subjective patient reports on their symptoms
were evaluated.
Results:
Spinal cord stimulation improves six-minute walk distance, exercise duration, New
York Heart Association functional class, Likert score, and number of angina free days
per week for at least one year over two years of follow-up.
Conclusion:
Spinal cord stimulation is an effective medium-term treatment option for refractory
angina pectoris with significant benefits to functional parameters and patient symptoms.
Spinal cord stimulation is an under-utilized but well-established modality for the
treatment of intractable angina pain. We report a small case series clinical audit
of patients who gained significant functional and symptomatic benefits from this treatment.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical outcome of patients treated with spinal cord stimulation for therapeutically refractory angina pectoris.Heart. 1999; 82: 82-88
- Spinal cord stimulation significantly decrease the need for acute hospital admission for chest pain in patients with refractory angina pectoris.Heart. 1999; 82: 89-92
- Central and peripheral electrical stimulation of the nervous system in the treatment of chronic pain.Acta Neurochir (Wien). 1987; 38: 64-75
- Spinal cord stimulation in chronic intractable angina pectoris: a randomized, controlled efficacy study.Am Heart J. 1998; 136: 1114-1120
- Does pain relief with spinal cord stimulation for angina conceal myocardial infarction?.Br Heart J. 1994; 71: 419-421
- Safety aspects of spinal cord stimulation in severe angina pectoris.Coronary Artery Dis. 1994; 5: 845-850
- Complications in spinal cord stimulation for treatment of angina pectoris.Acta Cardiologica. 1997; LII: 325-333
- Dorsal column stimulation for pain relief from intractable angina pectoris.Pain. 1987; 28: 365-368
- Effect of spinal cord stimulation on regional myocardial perfusion assessed by positron emission tomography.Am J Cardiol. 1992; 69: 1143-1149
- Spinal cord stimulation causes redistribution in myocardial perfusion during dipyridamole stgress testing in patients with refractory angina pectoris as assessed by 13 NH3 positron emission tomography.Am J Cardiol. 1996; 77: 462-467
- Effect of spinal cord stimulation on myocardial blood flow assessed by positron emission tomography in patients with refractory angina pectoris.Am J Cardiol. 1996; 77: 462-467
- Electrical stimulation versus coronary artery bypass surgery in severe angina pectoris: the ESBY study.Circulation. 1998; 97: 1157-1163
- Long term effects of spinal cord stimulation and coronary artery bypass grafting on quality of life and survival in the ESBY study [Comment].Eur Heart J. 2002; 23: 1938-1945
- Cost-effectiveness of spinal cord stimulaiton versus coronary artery bypass grafting in patients with severe angina pectoris—long term results from the ESBY study.Cardiology. 2003; 99: 20-24
- Effects of spinal cord stimulation in angina pectoris induced by pacing and possible mechanisms of action.Br Med J. 1993; 301: 477-480
- Myocardial turnover of endogenous opioids and CGRP in the human heart and the effects of SCS on pacing-induced angina pectoris.Cardiology. 1998; 89: 170-177
- Effects of spinal cord stimulation on myocardial ischaemia during daily life in patients with severe coronary artery disease.Br Heart J. 1994; 71: 413-418
Article info
Identification
Copyright
© 2005 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
