Abstract

Carotid sinus nerve (CSN) stimulators were inserted in 13 patients with intractable angina pectoris following surgical procedures to increase myocardial blood flow and relieve their angina. In all patients the CSN stimulation assisted to some degree in relieving angina. In some, a variation of the stimulation level and pattern was necessary to relieve chest pain. Digitalis, diuretics, long-acting vasodilators, and occasionally narcotics, beta-adrenergic-receptor blocking agents, and nitroglycerin were necessary to control angina. The CSN stimulator is a useful adjunct to drug therapy in controlling angina pectoris. In 10 patients square-wave electromagnetic flow probe measurements showed a 21% decrease in bilateral common carotid artery blood flow during CSN stimulation. One of 3 patients with asymptomatic carotid arteriosclerotic plagues sustained a transient cerebrovascular accident following stimulator implantation. CSN stimulators are not recommended for patients with signs or symptoms of cerebrovascular disease because of the danger of cerebral embolization and reduction in cerebral blood flow during stimulation.

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