Electrical stimulation versus coronary artery bypass surgery in severe angina pectoris: the ESBY study

Circulation
C MannheimerA Hjalmarsson

Abstract

Spinal cord stimulation (SCS) has been shown to have antianginal and anti-ischemic effects in severe angina pectoris. The present study was performed to investigate whether SCS can be used as an alternative to coronary artery bypass grafting (CABG) in selected patient groups, ie, patients with no proven prognostic benefit from CABG and with an increased surgical risk. One hundred four patients were randomized (SCS, 53; CABG, 51). The patients were assessed with respect to symptoms, exercise capacity, ischemic ECG changes during exercise, rate-pressure product, mortality, and cardiovascular morbidity before and 6 months after the operation. Both groups had adequate symptom relief (P<.0001), and there was no difference between SCS and CABG. The CABG group had an increase in exercise capacity (P=.02), less ST-segment depression on maximum (P=.005) and comparable (P=.0009) workloads, and an increase in the rate-pressure product both at maximum (P=.0003) and comparable (P=.03) workloads compared with the SCS group. Eight deaths occurred during the follow-up period, 7 in the CABG group and 1 in the SCS group. On an intention-to-treat basis, the mortality rate was lower in the SCS group (P=.02). Cerebrovascular morbidity was also lowe...Continue Reading

References

Mar 1, 1990·British Heart Journal·J E Sanderson
Jan 1, 1988·British Heart Journal·C MannheimerC Wilhelmsson
Nov 10, 1988·The New England Journal of Medicine·G L ReedR W DeSanctis
Jan 1, 1987·Acta neurochirurgica. Supplementum·J Gybels, R Kupers
Sep 1, 1986·Pain·Clas MannheimerClas Wilhelmsson
Aug 1, 1982·European Heart Journal·C MannheimerC Wilhelmsson
Apr 1, 1995·The Thoracic and Cardiovascular Surgeon·G Brandrup-WognsenB J Herlitz
Sep 1, 1993·Coronary Artery Disease·T EliassonC Mannheimer
Jan 1, 1995·Stereotactic and Functional Neurosurgery·L E AugustinssonC Mannheimer

❮ Previous
Next ❯

Citations

Sep 23, 2011·Der Schmerz·V TronnierUNKNOWN Arbeitsgruppe zur Erstellung der S3-Leitlinie
Mar 17, 2001·Current Pain and Headache Reports·M P Stojanovic
Jan 8, 2009·Current Pain and Headache Reports·Timothy R Deer
Mar 19, 2013·Current Pain and Headache Reports·Tilman Wolter, Holger Kaube
Mar 17, 2004·Current Treatment Options in Cardiovascular Medicine·Wilbert S. Aronow, William H. Frishman
May 26, 2005·Current Treatment Options in Cardiovascular Medicine·C Richard Conti
Jan 13, 2006·Current Treatment Options in Cardiovascular Medicine·Udho Thadani
Sep 4, 2007·The American Journal of Medicine·Gregory Angelo Sgueglia, Alfonso Sestito
Jan 1, 2008·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Steven FalowskiAshwini Sharan
Nov 30, 1999·Lancet·A Brodison, A Chauhan
Sep 12, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Nelson SvorkdalUNKNOWN American Heart Association
Feb 3, 2000·Journal of the American College of Surgeons·W Kaakaji, K J Burchiel
Mar 5, 2002·Autonomic Neuroscience : Basic & Clinical·J A ArmourR D Foreman
Jul 1, 2002·Neuromodulation : Journal of the International Neuromodulation Society·Malvern S MaySimon J Thomson
Jan 1, 2003·Neuromodulation : Journal of the International Neuromodulation Society·Richard B North
Sep 30, 1999·The New England Journal of Medicine·R A Lange, L D Hillis
May 15, 2013·European Heart Journal·Timothy D HenryJay H Traverse
Oct 1, 2006·Neuromodulation : Journal of the International Neuromodulation Society·Claus AndersenChristian Scherer
Mar 1, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Gaetano Antonio LanzaAntonio Di Monaco
Apr 13, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Douglas P ZipesChristopher Irwin
Nov 20, 1998·BMJ : British Medical Journal·T J NurmikkoJ R Wiles
Jan 24, 2007·Heart·Gregory Angelo SguegliaGaetano Antonio Lanza
Apr 17, 2007·Heart·Gaetano A Lanza
Jun 7, 2007·Postgraduate Medical Journal·Miriam J Johnson
Jun 29, 2007·BMC Cardiovascular Disorders·Jessica de VriesFelix Zijlstra
Mar 8, 2007·Neurosurgical Focus·Oren Sagher, Dah-Luen Huang
Jul 12, 2003·Journal of Neurosurgery·Oren SagherRichard F Keep
Jul 6, 2000·Journal of Neurosurgery·O Sagher, D L Huang
Mar 1, 2012·Pain Management·Krishna KumarSyed Rizvi
Dec 12, 2012·Surgical Neurology International·Claudio YampolskyDamián Bendersky
Jul 6, 2014·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Milos DobiasPaul Johnston
Aug 17, 1999·Current Opinion in Cardiology·U Thadani
Aug 11, 2006·Current Opinion in Cardiology·Ami B Bhatt, Peter H Stone
Jan 1, 1999·Neuromodulation : Journal of the International Neuromodulation Society·N C VulinkM J Dejongste

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.