Effects of spinal cord stimulation on myocardial ischaemia during daily life in patients with severe coronary artery disease. A prospective ambulatory electrocardiographic study
| Autor: | M. J. L. De Jongste, Michiel J. Staal, J. Haaksma, Rwm Hautvast, Kong I. Lie, P. W. J. Meyler, Hans L. Hillege, J. E. Sanderson |
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| Rok vydání: | 1994 |
| Předmět: |
Cord
integumentary system medicine.diagnostic_test Unstable angina business.industry Ischemia medicine.disease Angina Coronary artery disease nervous system Anesthesia Ambulatory medicine cardiovascular diseases Cardiology and Cardiovascular Medicine Prospective cohort study business tissues Electrocardiography |
| Zdroj: | Heart. 71:413-418 |
| ISSN: | 1355-6037 |
| DOI: | 10.1136/hrt.71.5.413 |
| Popis: | BACKGROUND--Spinal cord stimulation (SCS) may be a useful additional therapy for pain in patients with therapeutically refractory angina pectoris. But doubts remain about whether it also relieves ischaemia. METHODS--Indices of ischaemia were studied with and without SCS in 10 patients with otherwise intractable angina and evidence of myocardial ischaemia on 48 h ambulatory electrocardiographic (ECG) recording. Primary end points assessed by 48 h ECG recordings were total ischaemic burden, number of ischaemic episodes, and duration of ischaemic episodes. In addition, symptoms were assessed by a diary of glyceryl trinitrate intake and angina attacks. RESULTS--During SCS the total ischaemic burden of the entire group was 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 patients there was no myocardial ischaemia during 48 h ambulatory ECG monitoring with SCS. The number of ischaemic episodes was reduced from a median of 3 (1-15) before SCS to 0 (0-9) with SCS (p < 0.04). The duration of ischaemic episodes decreased from a median of 20.6 (1.7-155.4) min before SCS to 0 (0-48.3) min with SCS (p < 0.03). This was accompanied 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 (0-10) per 48 h with SCS (p < 0.03). CONCLUSIONS--SCS not only reduced symptoms but also myocardial ischaemia. Therefore, SCS appears to be both a safe and an effective therapy for patients with refractory angina. |
| Databáze: | OpenAIRE |
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