Spinal cord stimulation for angina pectoris: Remote observations
DOI:
https://doi.org/10.47924/neurotarget2009316Keywords:
angina pectoris, angor pectoris, spinal cord stimulation, coronary X syndromeAbstract
Background: Chronic refractory angina pectoris is defined as chest pain for heart failure that can not be controlled by regular medication nor by revascularization techniques but by spinal cord stimulation (SCS).
Materials and method: Between 1999 and 2000 three patients with ages between 52 and 62 and placed in classes III and IV, as the New York Heart Association Functional Class (NYHA-FC), were undergone to spinal cord stimulation with an electrode tetrapolar type “paddle” placed in the epidural space at T1, left paramedian, through a medial minilaminectomy; then, in the same surgical time, the electrode was connected to a programmable pulse generator. All patients have had at least one bypass surgery. One patient was carrier of coronary X syndrome; the other two men had severe angina pain.
Results: At long term follow up, an improvement in NYHA-FC (3,5 to 2,2) and VAS scores was noted. There were no complications and clinical examinations clearly showed an improvement in quality of life and in carrying out physical activity, improvement of the ST segment in ECG, a significant decrease in intake of nitrates and reduction in time and frequency of periods of hospitalization.
Conclusions: Although small, this study demonstrates the beneficial effect of EM in chronic refractory angina. This procedure is considered as additional treatment of first choice for these pa- tients by the European Society of Cardiology and y the American College of Cardiology/American Heart Association Task Force assigned a level of evidence Class IIB.
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