Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
Epidural spinal electrical stimulation for severe angina: a study of its effects on symptoms, exercise tolerance and degree of ischaemia
Departments of Cardiology and Anaesthetics, The Taunton and Somerset Hospital, Musgrove Park Taunton, Somerset TA1 5DA, U.K
Received 11 February 1991; revised 17 June 1991; .
Correspondence Dr J. E. Sanderson, Department of Cardiology, Taunton and Somerset Hospital, Musgrove Park, Taunton, Somerset TA1 5DA, U.K.
Abstract
The effectiveness of epidural spinal electrical stimulation has been studied in 14 patients with severe intractable angina unresponsive to standard therapies including bypass grafting. After implantation of the neurostimulator units the patients were assessed by a symptom questionnaire, treadmill exercise testing and right atrial pacing. There was a significant improvement of symptoms andGTN consumption fell markedly. With the neurostimulator on, exercise duration increased from a mean (CI) of 414 (153) to 478 (149) s, and total ST segment depression was less both at maximum exercise (7.1 (4.5) vs 5.6 (4.2) mm) and at 90% of the maximum control heart rate (3.5 (3.7) vs 2.6 (4.3) mm), with similar rate-pressure product at maximum exercise. With right atrial pacing the maximum heart rate reached before onset of angina was increased (143 (14) to 150 (7) b. min–1) and total ST segment depression was less at all heart rates. Benefit has persisted in some patients for over 2 years without any apparent adverse sequelae. Epidural spinal electrical stimulation is, therefore, an alternative therapy for some patients with intractable angina which has not responded to standard therapies.
Key Words: Angina • ischaemia • neurostimulation
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