SPINAL CORD STIMULATION IN THE TREATMENT OF REFRACTORY ANGINA PECTORIS: 25-YEAR CLINICAL EXPERIENCE AT A SINGLE CENTER

Background:

The efficacy of spinal cord stimulation (SCS) in refractory angina pectoris (RAP) has been proven by several smaller randomized trials and one prospective randomized multicenter registry. Long-term evidence regarding the efficacy is scarce.

Aim: 

To report long-term clinical single-center data.

Sample and Methodology:

43 patients were implanted with SCS for the indication of RAP from 2000 until 2024 using quadri- or octopolar lead inserted in the epidural space targeting the T1-T4 spinal cord segments. Clinical data were obtained twice a year.

Results: 

Study population follow-up involved 320 patient years. There were no deaths or severe adverse events related to the implant procedure. Lead repositioning or other SCS system revision for non-infectious reasons was necessary in 7 patients. In three subjects, the system had to be explanted due to infection. In two patients, the stimulator was explanted for being unresponsive to the therapy. No interactions between SCS and other cardiac implantable electronic devices were detected.

We observed short-term (6 months) improvement in on all tested clinical parameters (angina severity and frequency, quality of life, physical limitation) with SCS compared to baseline. However, the effect of the therapy persisted throughout the entire follow-up. The severity of angina according to the Visual Analogue Scale (VAS) of pain decreased from 7.4 ± 1.7 at baseline to 2.5 ± 1.5 at 6 months (n = 20), 2.4 ± 1.4 at 5 years (n = 13), 2.0 ± 1.0 at 10 years (n = 9) and 1.7 ± 0.7 at 5 years (n = 5; all p-values were

Conclusion: 

Our data suggest that SCS is an effective therapy for RAP, with persistent long-term efficacy and favorable safety profile.