High cervical spinal cord stimulation for unstable angina pectoris.

Twelve patients with grade IV unstable angina were treated with high cervical spinal cord stimulation (SCS). All patients had been previously treated with maximal tolerated doses of beta-blockers and calcium antagonists and had no possibility of revascularization surgery or intraluminal angioplasty. Multipolar electrodes were implanted using a percutaneous technique, and the parameters of stimulation were pulse width 0.1 ms, frequency 120 Hz, intensity that caused no unpleasant paresthesias, with two periods of 4 h 'on' daily. After a mean follow-up of 9.8 +/- 8.2 months the clinical results show a significant reduction in the number of angina attacks (p less than 0.01) and in their grade (p less than 0.001). In the treadmill ergometric test, a significant increase in the time until angina and double product (p less than 0.01) was observed. We conclude that the SCS is a very low-risk technique that significantly increases the quality of life of patients with unstable angina.