Spinal cord stimulation significantly decreases the need for acute hospital admission for chest pain in patients with refractory angina pectoris

Objective-To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pec toris. Design-Retrospective analysis of case records. Patients-19 consecutive patients implanted for SCS between 1987 and 1997. A ll had three vessel coronary disease, and all were in New York Heart Associ ation functional group III/IV. Methods-Admission rates were calculated for three separate periods: (1) fro m initial presentation up until last revascularisation; (2) from last revas cularisation until SCS implantation; (3) from SCS implantation until the st udy date. Post-revascularisation rates were then compared with post-SCS rat es, without including admissions before revascularisation, as this would bi as against revascularisation procedures. Results-Annual admission rate after revascularisation was 0.97/patient/year , compared with 0.27 after SCS (p = 0.02). Mean time in hospital/patient/ye ar after revascularisation was 8.3 days upsilon 2.5 days after SCS (p = 0.0 4). No unexplained new ECG changes were observed during follow up and patie nts presented with unstable angina and acute myocardial infarction in the u sual way. Conclusions-SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leadi ng to silent infarction.