The effect of electrical neurostimulation on collateral perfusion during acute coronary occlusion.

Electrical neurostimulation can be used to treat patients with refractory angina, it reduces angina and ischemia. Previous data have suggested that electrical neurostimulation may alleviate myocardial ischaemia through increased collateral perfusion. We investigated the effect of electrical neurostimulation on functional collateral perfusion, assessed by distal coronary pressure measurement during acute coronary occlusion. We sought to study the effect of electrical neurostimulation on collateral perfusion in a cross-over design.




Methods:

Sixty patients with stable angina and significant coronary artery disease planned for elective percutaneous coronary intervention were split in two groups. In all patients two balloon inflations of 60 seconds were performed, the first for balloon pre-dilatation of the lesion (first episode), the second for stent delivery (second episode). The Pw/Pa ratio (wedge pressure / aortic pressure) was measured during both ischaemic episodes. Group 1 received active neurostimulation during the first episode, group 2 received active neurostimulation during the second episode.

Neurostimulation can improve collateral perfusion measured as a Pw/Pa ratio, during acute coronary occlusione.

N/A

The intervention was electrical neurostimulation, during 5 minutes before and during the 1-minute ischemic episode. Within a patient we measured during the 1-minute ischemic episode the collateral perfusion, with and without electrical neurostimulation. The ischemic episode was established by balloon inflation during elective PCI.