Abstract
BACKGROUND AND HYPOTHESIS: Treatment of patients with refractory chest pain remains a challenge. In this study, the long-term clinical effects of spinal cord electrical stimulation were evaluated in 10 consecutive male patients (mean age 53.7 years) with chronic chest pain in a prospective observational study. METHODS: After placement of the electrode in an epidural position and before implantation of the device, patients were subjected to clinical evaluation, including atrial pacing, in order to document significant antianginal effects. RESULTS: Spinal cord electrical stimulation abolished or improved pacing time to angina by more than 50% in seven of the patients who subsequently had the device implanted. In three of these patients, the system was ineffective after a period of 3-9 months despite paresthesia in the area of anginal pain with electrical stimulation. The effects of treatment remained 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 electrical stimulation is one of the few therapeutic options in inoperable patients with refractory chest pain.