Abstract
Introduction: We have demonstrated that HTEA is effective both acutely and chronically in relieving the symptoms of medically and surgically refractory angina pectoris. [1] However, the mechanism by which HTEA reduces angina pectoris during long term treatment has not been established. Therefore, we used stress thallium testing to evaluate improvement in myocardial blood flow during stress induced ischemia. Methods: In a retrospective fashion, 6 patients who had chronic (> 2 months) indwelling implantable epidural catheters were evaluated via pre-insertion and post- implant stress thallium perfusion studies. Results: Two of six patients had improvement, but not resolution of stress induced ischemia at 8 and 12 months, respectively. The remaining four patients had no change in stress induced ischemia. None of the six patients had any new areas of ischemia or infarction as determined by their stress thalliums. (Table 1)Table 1Conclusions: HTEA does relieve the pain of angina pectoris in patients who are refractory to medical and surgical management. [1] The data does not support a significant improvement in myocardial blood flow distribution during stress. However, there is no evidence that disease progression occurs since no patients had evidence of new areas of ischemia or infarctions.
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