EFFECTS OF SPINAL-CORD STIMULATION ON MYOCARDIAL-ISCHEMIA DURING DAILY-LIFE IN PATIENTS WITH SEVERE CORONARY-ARTERY DISEASE - A PROSPECTIVEAMBULATORY ELECTROCARDIOGRAPHIC STUDY - ABSTRACTS

Background-Spinal cord stimulation (SCS) may be a useful additional th erapy for pain in patients with therapeutically refractory angina pect oris. But doubts remain about whether it also relieves ischaemia. Meth ods-Indices of ischaemia were studied with and without SCS in 10 patie nts with otherwise angina and evidence of ischaemia on 48 h ambulatory electrocardiographic (ECG) recording. Primary end points assessed by 48 h ECG recordings were total ischaemic burden, number of ischaemic e pisodes, and duration of ischaemic episodes. In addition, symptoms wer e assessed by a diary of glyceryl trinitrate intake and anginal attack s. Results-During SCS the total ischaemic burden of the entire group w as significantly reduced from a median of 27.9 (1.9-278.2) before SCS to 0 (0-70.2) mm x min with SCS (p < 0.03). In six out of the 10 patie nts there was no myocardial ischaemia during 48 h ambulatory ECG monit oring with SCS. The number of ischaemic episodes was reduced from a me dian of 3 (1-15) before SCS to 0 (0-9) with SCS (p < 0.04). The durati on of ischaemic episodes decreased from a median of 20.6 (1 7-155.4) m in before SCS to 0 (0-48.3) min with SCS (p < 0.03). This was accompan ied by a significant improvement in symptoms with a reduction in daily glyceryl trinitrate intake from a median of 3 0 (0-10) before SCS to 0.3 (0-10) tablets per 48 h (p < 0.02) and a decrease in the frequency of anginal attacks from a median of 5.5 (2-14) before SCS to 1.0 (0-1 0) per 48 h with SCS (p < 0.03). Conclusions-SCS not only reduced symp toms but also myocardial ischaemia. Therefore, SCS appears to be both a safe and an effective therapy for patients with refractory angina.