S Murray1, K G Carson, P D Ewings, P D Collins, M A James. 1. Department of Cardiology, Taunton and Somerset Hospital, Musgrove Park, Taunton Somerset TA1 5DA, UK. doc.steve.murray@mailexcite.com
Abstract
OBJECTIVE: To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris. DESIGN: Retrospective analysis of case records. PATIENTS: 19 consecutive patients implanted for SCS between 1987 and 1997. All had three vessel coronary disease, and all were in New York Heart Association functional group III/IV. METHODS: Admission rates were calculated for three separate periods: (1) from initial presentation up until last revascularisation; (2) from last revascularisation until SCS implantation; (3) from SCS implantation until the study date. Post-revascularisation rates were then compared with post-SCS rates, without including admissions before revascularisation, as this would bias 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/year after revascularisation was 8.3 days v 2.5 days after SCS (p = 0.04). No unexplained new ECG changes were observed during follow up and patients presented with unstable angina and acute myocardial infarction in the usual way. CONCLUSIONS: SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leading to silent infarction.
OBJECTIVE: To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris. DESIGN: Retrospective analysis of case records. PATIENTS: 19 consecutive patients implanted for SCS between 1987 and 1997. All had three vessel coronary disease, and all were in New York Heart Association functional group III/IV. METHODS: Admission rates were calculated for three separate periods: (1) from initial presentation up until last revascularisation; (2) from last revascularisation until SCS implantation; (3) from SCS implantation until the study date. Post-revascularisation rates were then compared with post-SCS rates, without including admissions before revascularisation, as this would bias 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/year after revascularisation was 8.3 days v 2.5 days after SCS (p = 0.04). No unexplained new ECG changes were observed during follow up and patients presented with unstable angina and acute myocardial infarction in the usual way. CONCLUSIONS: SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leading to silent infarction.
Authors: J Broseta; J Barberá; J A de Vera; J L Barcia-Salorio; G Garcia-March; J González-Darder; F Rovaina; V Joanes Journal: J Neurosurg Date: 1986-01 Impact factor: 5.115
Authors: H Norrsell; T Eliasson; C Mannheimer; L E Augustinsson; C H Bergh; B Andersson; F Waagstein; P Friberg Journal: Eur Heart J Date: 1997-12 Impact factor: 29.983
Authors: Stephan Eddicks; Klaus Maier-Hauff; Michael Schenk; Andreas Müller; Gert Baumann; Heinz Theres Journal: Heart Date: 2007-01-19 Impact factor: 5.994
Authors: M T Dyer; K A Goldsmith; S N Khan; L D Sharples; C Freeman; I Hardy; M J Buxton; P M Schofield Journal: Trials Date: 2008-06-30 Impact factor: 2.279