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Related Concept Videos

Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

449
Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
449

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Updated: May 31, 2025

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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Spinal Cord Stimulation for Refractory Angina Pectoris: Current Status and Future Perspectives, a Narrative Review.

Roberto Gazzeri1, Jacopo Mosca2, Felice Occhigrossi1

  • 1Interventional and Surgical Pain Management Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy.

Journal of Cardiovascular Development and Disease
|January 24, 2025
PubMed
Summary

Spinal cord stimulation (SCS) effectively manages refractory angina pectoris (RAP) by reducing chest pain and improving quality of life. This therapy offers a safe alternative for patients ineligible for surgery.

Keywords:
angina pectorisburstclosed loopdtmhigh frequencymyocardial ischemianeurostimulationquality of liferefractory angina pectorisspinal cord stimulationtonic stimulation

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Area of Science:

  • Cardiology
  • Neuromodulation
  • Pain Management

Background:

  • Refractory angina pectoris (RAP) presents persistent chest pain from myocardial ischemia, often unresponsive to standard treatments.
  • Spinal cord stimulation (SCS) is an emerging therapy for RAP, aiming to alleviate symptoms and enhance patient well-being.

Purpose of the Study:

  • To systematically review the clinical effectiveness, mechanisms, and safety of SCS in treating refractory angina pectoris.
  • To evaluate the impact of SCS on anginal episodes, medication use, exercise capacity, and quality of life.

Main Methods:

  • A systematic literature review was conducted, searching PubMed, Scopus, and Web of Science for studies from 1990 to 2023.
  • Six studies met the inclusion criteria, providing data on SCS for RAP management.

Main Results:

  • SCS significantly reduced anginal episodes and nitroglycerin use.
  • Patients receiving SCS experienced improved exercise capacity and quality of life.
  • Mechanisms include pain signal modulation, autonomic balance enhancement, and improved myocardial perfusion.

Conclusions:

  • SCS is a safe and effective treatment for RAP patients unsuitable for surgical interventions.
  • Novel SCS modalities and future innovations like closed-loop systems show promise for optimizing outcomes.
  • Further rigorous clinical trials are needed to establish SCS as a primary therapy for RAP.