Spinal cord stimulation (SCS) for refractory angina pectoris

Since 2001, we have provided pain relief to patients with refractory angina pectoris using surgically implanted spinal cord stimulation devices. About 60 patients have been treated, and 90% of these have been satisfied with the result. Following the procedure, patients experience fewer angina attacks, spend less time as in-patients, and are capable of increased activity. Patients are cared for by a group including a cardiologist, an anesthesiologist, a physiotherapist, and a nurse.

Candidates for SCS are patients with refractory angina; that is, angina in function class III-IV that is not helped by a combination of medical treatment, PCI, and/or coronary artery bypass grafting (CABG).

In the SCS unit, the evaluation begins with a TENS fitting. The patient uses TENS at home for 4 weeks, and then returns for evaluation. If the effect is good as judged by less pain, increased mobility, and less use of nitro medication, the patient is considered to be a candidate for surgery. Myocardial scintigraphy or stress echocardiography is carried out to look for a reversible ischemia, which supports the indication for SCS.

During the procedure, which is carried out under local anesthesia, SCS is tested to find the area of paresthesia over the angina area. The patient can be discharged the day after the procedure. Follow-up is carried out two weeks, three months, six months, and then every year after the procedure.

Patients who could be helped by SCS can be referred for evaluation to the SCS unit at the heart unit at Örebro University Hospital. We are also available for discussion, preferably via correspondence with information on the patient’s condition, medicines, other diseases, angiographic results, and objective studies of ischemia. 

Page revised Wednesday, May 11, 2011

Content manager: Kjeld Christensen

Published by Anita Pettersson


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