An evidence-based review of neuromodulation for the treatment and management of refractory angina

Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):517-528. doi: 10.1016/j.bpa.2020.08.006. Epub 2020 Aug 7.

Abstract

Angina pectoris is defined as substernal chest pain that is typically exacerbated by exertion, stress, or other exposures. There are various methods of treatment for angina. Lifestyle modification and pharmacological management are considered as conservative treatments. If these medications do not result in the resolution of pain, more invasive approaches are an option, like coronary revascularization. Refractory angina (RA) is differentiated from acute or chronic angina based on the persistence of symptoms despite conventional therapies. Overall, the prevalence of RA is estimated to be 5%-15% in patients with coronary artery disease, which can account for up to 1,500,000 current cases and 100,000 new cases in the United States per year. Spinal cord stimulation treatment is a viable option for patients who are suffering from RA pain and are either not candidates for revascularization surgery or are currently not being well managed on more traditional treatments. Many studies show a positive result.

Keywords: chronic angina; neuromodulation; refractory angina; spinal cord stimulation.

Publication types

  • Review

MeSH terms

  • Angina Pectoris / diagnosis
  • Angina Pectoris / physiopathology
  • Angina Pectoris / therapy*
  • Evidence-Based Medicine / methods*
  • Humans
  • Pain Management / methods*
  • Pain, Intractable / diagnosis
  • Pain, Intractable / physiopathology
  • Pain, Intractable / therapy*
  • Risk Reduction Behavior
  • Spinal Cord Stimulation / methods*
  • Transcutaneous Electric Nerve Stimulation / methods*
  • Treatment Outcome