Spinal cord stimulation for the treatment of refractory angina pectoris

Spinal cord stimulation (SCS) is a well known method of treatment used worldwide since the 80's of the last century. High efficiency of SCS was observed in the treatment of various types of pain. Promising clinical results were observed in the treatment of patients with refractory angina (RA). Reduction of angina attacks reduces closes of medications and improves quality of life. SCS efficacy in RA is comparable to that observed among patients treated with cardiac surgery (CABG) and percutaneous coronary intervention (PCI), with lower risk of complications and rehospitalisation. SCS is more cost effective compared to CABG and PCI. SCS might be considered for patients who did not respond to reperfusion therapy. The mechanism of action in RA is not well understood. It is known that SCS reduces the activity of the sympathetic nervous system, by which improves the coronary perfusion and oxygenation of the heart muscle. It is important that SCS does not mask the pain related to the infarct.