LONG-TERM OUTCOME OF SPINAL-CORD ELECTRICAL-STIMULATION IN PATIENTS WITH REFRACTORY CHEST PAIN

Background and hypothesis: Treatment of patients with refractory chest pain remains a challenge. In this study, the long-term clinical effec ts of spinal cord electrical stimulation were evaluated in 10 consecut ive male patients (mean age 53.7 years) with chronic chest pain in a p rospective observational study. Methods: After placement of the electr ode in an epidural position and before implantation of the device, pat ients were subjected to clinical evaluation, including atrial pacing, in order to document significant antianginal effects. Results: Spinal cord electrical stimulation abolished or improved pacing tine to angin a by more than 50% in seven of the patients who subsequently had the d evice implanted. In three of these patients, the system was ineffectiv e after a period of 3-9 months despite paresthesia in the area of angi nal pain with electrical stimulation. The effects of treatment remaine d satisfactory in the remaining patients (40%) after a mean follow-up of 60 (45-72) months. Thus, a long-lasting clinical response was able to be predicted in 57% of the patients. Conclusion: Spinal cord electr ical stimulation is one of the few therapeutic options in inoperable p atients with refractory chest pain.