Eliasson T, Jern S, Augustinsson L E, Mannheimer C
Department of Internal Medicine, Ostra Hospital, Göteborg, Sweden.
Coron Artery Dis. 1994 Oct;5(10):845-50.
Spinal cord stimulation has been used over the past decade for the treatment of patients suffering from intractable angina pectoris, despite having received optimal medical therapy, and who are unsuitable for further surgical intervention. The clinical results are promising and several studies have shown that the antianginal effect of the treatment is associated with a reduction in myocardial ischemia. It has been suggested, however, that spinal cord stimulation may only attenuate the transmission of pain from the heart, without influencing myocardial ischemia. This is a major safety concern when applying this treatment strategy.
The aim of this study was to assess the potentially unfavourable aspects of spinal cord stimulation in patients with severe coronary artery disease and angina pectoris by means of repeated long-term ECG recordings. Nineteen patients who had been accepted for implantation of spinal cord stimulators for the treatment of severe angina pectoris were included.
No increases were noted in the frequency of ischemic episodes, the total ischemic burden, or the number of arrhythmic episodes during treatment.
The results of this study do not indicate any unfavourable effects of spinal cord stimulation in severe angina pectoris in terms of an increase in the frequency or severity of myocardial ischemia during treatment with spinal cord stimulation.
在过去十年中，脊髓刺激已被用于治疗尽管接受了最佳药物治疗但仍患有顽固性心绞痛且不适合进一步手术干预的患者。临床结果令人鼓舞，多项研究表明该治疗的抗心绞痛作用与心肌缺血的减轻有关。然而，有人提出脊髓刺激可能仅减弱来自心脏的疼痛传递，而不影响心肌缺血。在应用这种治疗策略时，这是一个主要的安全问题。
本研究的目的是通过重复的长期心电图记录来评估脊髓刺激对严重冠状动脉疾病和心绞痛患者的潜在不利影响。纳入了19名因治疗严重心绞痛而被接受植入脊髓刺激器的患者。
治疗期间缺血发作频率、总缺血负担或心律失常发作次数均未增加。
本研究结果并未表明脊髓刺激在严重心绞痛治疗中会因脊髓刺激治疗期间心肌缺血频率或严重程度增加而产生任何不利影响。
