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Spinal cord stimulation in chronic intractable angina pectoris: a randomized, controlled efficacy study
R W Hautvast1, M J DeJongste, M J Staal
1Department of Cardiology and Department of Neurosurgery, University Hospital Groningen, The Netherlands.
American Heart Journal
|December 8, 1998
Summary
Spinal cord stimulation effectively treats chronic intractable angina pectoris by improving exercise capacity and reducing ischemic episodes. The benefits are anti-ischemic, not solely due to a placebo effect from surgery.
Area of Science:
- Cardiology
- Neurology
- Pain Management
Background:
- Chronic intractable angina pectoris remains a challenge.
- Spinal cord stimulation (SCS) shows promise for angina treatment.
- The role of placebo effect in SCS for angina is unclear.
Purpose of the Study:
- To investigate the clinical efficacy of SCS for chronic angina.
- To determine if SCS effects are anti-ischemic.
- To assess the contribution of placebo effect to SCS outcomes.
Main Methods:
- A 6-week study comparing SCS treatment in 13 patients with 12 controls.
- Evaluated exercise capacity, ischemia, anginal attacks, nitrate use, and quality of life.
- Utilized exercise electrocardiograms and 48-hour ECG monitoring.
Main Results:
- SCS significantly improved exercise duration and time to angina.
- Reduced anginal attacks, nitrate consumption, and ischemic episodes.
- Enhanced perceived quality of life and decreased pain.
Conclusions:
- Spinal cord stimulation is an effective treatment for chronic intractable angina.
- The therapeutic effects are primarily anti-ischemic.
- Placebo effect from surgery is unlikely to explain the observed efficacy.