title: The effect of electrical neurostimulation on collateral perfusion.
abstract: OBJECTIVE
  Clinical data have shown that electrical neurostimulation may improve myocardial ischaemia. Our aim was to investigate the possible effect of electrical neurostimulation on collateral perfusion.
  
  
  METHODS
  Thirty patients with stable angina and significant single-vessel coronary artery disease scheduled for elective percutaneous coronary intervention (PCI) were randomised into three groups. In all patients two balloon inflations were performed, one for predilatation of the lesion, the second for stent delivery. Group one received active neurostimulation during the first ischaemic episode (predilatation), group two during the second ischaemic episode (stent delivery), and group three received placebo neurostimulation continuously. During both ischaemic episodes the collateral flow index was determined.
  
  
  RESULTS
  No significant differences were found between active, inactive or placebo neurostimulation. In a post-hoc analysis the patients were stratified for presence or absence of significant collaterals. In patients with pre-existing significant collaterals, the collateral flow index was significantly higher during active neurostimulation compared with inactive neurostimulation (p=0.012) and compared with the merged inactive and placebo groups (p=0.011).
  
  
  CONCLUSIONS
  The present data show no effect of electrical neurostimulation on collateral perfusion in patients with single-vessel disease. In a post-hoc analysis in patients with evidence of collaterals, defined as a collateral flow index of >0.24, an increase in collateral perfusion was found during electrical neurostimulation.
authors.forename: J
authors.initials: J
authors.lastname: de Vries
authors.forename: R L
authors.initials: RL
authors.lastname: Anthonio
authors.forename: M J L
authors.initials: MJ
authors.lastname: DeJongste
authors.forename: G A
authors.initials: GA
authors.lastname: Jessurun
authors.forename: R A
authors.initials: RA
authors.lastname: Tio
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
keywords: angina pectoris; angioplasty; collateral perfusion; electrical neurostimulation