This new technique is still the subject of ongoing research. It is used in patients with intractable angina who cannot be treated with angioplasty or bypass surgery-either because the coronary vessels are too diseased to undergo those procedures or because the patient's other medical problems make them too high a risk for those procedures.
The procedure is performed with only a local anesthetic. An electrode is placed inside of the tissues that surround the spinal column in the upper back. The electrode is connected to an electrical generator that sits beneath the skin under the left rib cage. The generator emits a weak electrical signal several times daily which is used to prevent angina. In addition, the patient can trigger the generator to emit a stronger signal in case any angina breaks through to terminate that attack.
The electrical spinal stimulation seems to help the heart get by with less blood flow by reducing its oxygen demand. Angina, and the need for antianginal medications, is reduced. The efficacy in reducing angina appears comparable to that of bypass surgery in preliminary studies with no adverse effect on overall patient survival.
Further research is needed before this novel technique can be considered part of the standard armamentarium for the treatment of coronary artery disease.
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