title: Long-term follow-up of patients with cardiac syndrome X treated by spinal cord stimulation.
abstract: OBJECTIVE
  To assess the long-term effect of spinal cord stimulation (SCS) in patients with refractory cardiac syndrome X (CSX).
  
  
  METHODS
  A prospective, controlled, long-term follow-up was performed of 19 patients with CSX with refractory angina who underwent SCS (SCS group, 5 men, mean (SD) age 60.9 (8.5) years); 9 comparable patients with CSX who refused SCS treatment (3 men, mean (SD) age 60.9 (8.8) years) constituted the control group. Clinical and functional status were assessed at the time of screening for SCS indication (basal evaluation) and at a median (range) follow-up of 36 (15-82) months.
  
  
  RESULTS
  The two groups at baseline did not show any difference in clinical characteristics and angina status. All indicators of angina status (angina episode frequency, duration and short-acting nitrate use) improved significantly at follow-up in the SCS group (p<0.001) but not in controls. Functional status, as assessed by the Seattle Angina Questionnaire and a visual analogue scale for quality of life, improved at follow-up in the SCS group (p<0.001 for all scales) but not in controls. Exercise tolerance, exercise-induced angina and ST segment changes also significantly improved in the SCS group but not in controls.
  
  
  CONCLUSIONS
  Data show that SCS can be a valid form of treatment for long-term control of angina episodes in patients with refractory CSX.
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Gregory Angelo
authors.initials: GA
authors.lastname: Sgueglia
authors.forename: Alfonso
authors.initials: A
authors.lastname: Sestito
authors.forename: Antonella
authors.initials: A
authors.lastname: Spinelli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Cioni
authors.forename: Fabio
authors.initials: F
authors.lastname: Infusino
authors.forename: Fabio
authors.initials: F
authors.lastname: Papacci
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci
authors.forename: Mario
authors.initials: M
authors.lastname: Meglio
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.forename: Gaetano Antonio
authors.initials: GA
authors.lastname: Lanza
mesh_terms: D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D017566:Microvascular Angina / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D013116:Spinal Cord / Q000502:physiology*; D016896:Treatment Outcome