SPINAL-CORD STIMULATION IN SEVERE ANGINA-PECTORIS

Over 200 patients suffering from severe angina pectoris and functionally referred to grade III and IV according to the New York Heart Association (NYHA) scale, have been treated with spinal cord stimulation (SCS). The clinical results regarding pain relief and Quality of Life have been very good. All patients have been considered as not suitable candidates for first hand treatment alternatives such as coronary by pass grafting or intraarterial invasive techniques (i.e. PTCA and Stent). Our studies have shown that SCS has anti-anginal and anti-ischemic effects and that a putative underlying physiological mechanism might be segmental inhibition of the activity on the sympathetic nervous system to the heart thus causing an increase of microcirculation, improved metabolism and a lesser myocardial demand of oxygen. It has also been proven that SCS does not mask ischemia at high work-load situations.