Spinal cord stimulation significantly decreases the need for acute hospital admission for chest pain in patients with refractory angina pectoris.
نویسندگان
چکیده
OBJECTIVE To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris. DESIGN Retrospective analysis of case records. PATIENTS 19 consecutive patients implanted for SCS between 1987 and 1997. All had three vessel coronary disease, and all were in New York Heart Association functional group III/IV. METHODS Admission rates were calculated for three separate periods: (1) from initial presentation up until last revascularisation; (2) from last revascularisation until SCS implantation; (3) from SCS implantation until the study date. Post-revascularisation rates were then compared with post-SCS rates, without including admissions before revascularisation, as this would bias against revascularisation procedures. RESULTS Annual admission rate after revascularisation was 0.97/patient/year, compared with 0.27 after SCS (p = 0.02). Mean time in hospital/patient/year after revascularisation was 8.3 days v 2.5 days after SCS (p = 0.04). No unexplained new ECG changes were observed during follow up and patients presented with unstable angina and acute myocardial infarction in the usual way. CONCLUSIONS SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leading to silent infarction.
منابع مشابه
Spinal Cord Stimulation for Refractory Angina Pectoris -A Case Report-
Refractory angina pectoris is defined as angina refractory to optimal medical treatment and standard coronary revascularization procedures. Despite recent therapeutic advances, patients with refractory angina pectoris are not adequately treated. Spinal cord stimulation is a minimally invasive and reversible technique which utilizes electrical neuromodulation by means of an electrode implanted i...
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OBJECTIVE To investigate the possibility that spinal cord stimulation (SCS) used for pain relief can conceal acute myocardial infarction (AMI). DESIGN Prospective evaluation of patients treated with SCS. SETTING University hospital. PATIENTS 50 patients with coronary artery disease and severe, otherwise intractable angina treated with SCS for 1-57 months. MAIN OUTCOME MEASURES Necropsy ...
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Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators....
متن کاملInterventional treatment of pain in refractory angina. A review.
BACKGROUND Refractory angina is characterized by repeated attacks of chest pain in patients on maximal anti-anginal pharmacotherapy, with a professional conscensus that further surgical or radiological revascularization would be futile. Refractory angina is a serious but relatively uncommon health problem, with a reported incidence of approximately 30 patients per million people/year. In this c...
متن کاملThe effectiveness and cost-effectiveness of spinal cord stimulation for refractory angina (RASCAL study): study protocol for a pilot randomized controlled trial
BACKGROUND The RASCAL (Refractory Angina Spinal Cord stimulation and usuAL care) pilot study seeks to assess the feasibility of a definitive trial to assess if addition of spinal cord stimulation (SCS) to usual care is clinically superior and more cost-effective than usual care alone in patients with refractory angina. METHODS/DESIGN This is an external pilot, patient-randomized controlled tr...
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ورودعنوان ژورنال:
- Heart
دوره 82 1 شماره
صفحات -
تاریخ انتشار 1999