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Transcutaneous electrical nerve stimulation in unstable angina pectoris
M Börjesson1, P Eriksson, M Dellborg
1Multidisciplinary Pain Center, Sahlgren's University Hospital/Ostra, Göteborg, Sweden.
Coronary Artery Disease
|August 1, 1997
Summary
Transcutaneous electrical nerve stimulation (TENS) may reduce silent ischemic events in unstable angina patients. This safe, additional treatment appears to decrease myocardial ischemia without affecting pain perception.
Area of Science:
- Cardiology
- Neurosurgery
Background:
- Silent ischemia is a significant predictor of poor outcomes in unstable angina pectoris.
- Dynamic continuous vector cardiography enables real-time detection of ischemic episodes.
- Transcutaneous electrical nerve stimulation (TENS) has shown potential antianginal effects, reducing myocardial ischemia.
Purpose of the Study:
- To evaluate the effectiveness of TENS as an additional treatment for unstable angina patients in a coronary care unit.
- To assess the impact of TENS on vector cardiographic and biochemical markers of ischemia.
Main Methods:
- A single-blind, placebo-controlled study involving 30 unstable angina patients.
- Continuous vector cardiography, cardiac enzyme leakage, and analgesic consumption were monitored over 24 hours.
- Patients were divided into TENS and placebo groups.
Main Results:
- TENS was well-tolerated and did not interfere with standard care, though it affected vectorcardiographic recordings during stimulation.
- A significant reduction in the number and duration of silent ischemic episodes was observed in the TENS group (P=0.02 and P=0.01, respectively).
- A trend towards reduced total ischemic episodes and cardiac enzyme leakage was noted, but without statistical significance.
Conclusions:
- TENS appears to be a safe adjunctive therapy for unstable angina pectoris.
- TENS may decrease the incidence of ischemic events through mechanisms independent of pain reduction.