EFFECTS OF SPINAL-CORD STIMULATION ON MYOCARDIAL-ISCHEMIA DURING DAILY-LIFE IN PATIENTS WITH SEVERE CORONARY-ARTERY DISEASE - A PROSPECTIVE AMBULATORY ELECTROCARDIOGRAPHIC STUDY - ABSTRACTS

MJL DEJONGSTE*, J HAAKSMA, RWM HAUTVAST, HL HILLEGE, PWJ MEYLER, MJ STAAL, JE SANDERSON, KI LIE

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

131 Citations (Scopus)

Abstract

Background-Spinal cord stimulation (SCS) may be a useful additional therapy for pain in patients with therapeutically refractory angina pectoris. But doubts remain about whether it also relieves ischaemia.

Methods-Indices of ischaemia were studied with and without SCS in 10 patients with otherwise angina and evidence of ischaemia on 48 h ambulatory electrocardiographic (ECG) recording. Primary end points assessed by 48 h ECG recordings were total ischaemic burden, number of ischaemic episodes, and duration of ischaemic episodes. In addition, symptoms were assessed by a diary of glyceryl trinitrate intake and anginal attacks.

Results-During SCS the total ischaemic burden of the entire group was significantly reduced from a median of 27.9 (1.9-278.2) before SCS to 0 (0-70.2) mm x min with SCS (p <0.03). In six out of the 10 patients there was no myocardial ischaemia during 48 h ambulatory ECG monitoring with SCS. The number of ischaemic episodes was reduced from a median of 3 (1-15) before SCS to 0 (0-9) with SCS (p <0.04). The duration of ischaemic episodes decreased from a median of 20.6 (1 7-155.4) min before SCS to 0 (0-48.3) min with SCS (p <0.03). This was accompanied by a significant improvement in symptoms with a reduction in daily glyceryl trinitrate intake from a median of 3 0 (0-10) before SCS to 0.3 (0-10) tablets per 48 h (p <0.02) and a decrease in the frequency of anginal attacks from a median of 5.5 (2-14) before SCS to 1.0 (0-10) per 48 h with SCS (p <0.03).

Conclusions-SCS not only reduced symptoms but also myocardial ischaemia. Therefore, SCS appears to be both a safe and an effective therapy for patients with refractory angina.

Original languageEnglish
Pages (from-to)413-418
Number of pages6
JournalBritish heart journal
Volume71
Issue number5
Publication statusPublished - May-1994

Keywords

  • ISCHEMIC HEART-DISEASE
  • SEVERE ANGINA-PECTORIS
  • ST-SEGMENT DEPRESSION
  • ELECTRICAL-STIMULATION
  • UNSTABLE ANGINA
  • T SEGMENT
  • VARIABILITY
  • MECHANISMS
  • BURDEN
  • NERVE

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