An investigation into the ‘carry over’ effect of neurostimulation in the treatment of angina pectoris

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SummaryNeurostimulation, by way of transcutaneous electrical nerve stimulation (TENS) and spinal cord stimulation, improves signs and symptoms of myocardial ischaemia, with evidence (from non-randomised studies) that this effect extends beyond the period of stimulation itself (‘carry-over’ effect). In this randomised controlled trial, 10 patients underwent baseline treadmill-exercise-testing (TET), followed by two further tests at fortnightly intervals. TENS was compared to placebo in a randomised fashion. TENS produced a significant increase in total exercise time (399.3 vs. 364.5 s, p < 0.05) and time to maximum ST depression (374 vs. 324 s, p = 0.01) without a significant difference in the maximum degree of ST depression (2.0 vs. 2.1 mm, p = NS). Rate-pressure product at peak exercise was not significantly different (197 vs. 193, p = NS). TENS produced a non-significant change in time to onset of angina (352 vs. 325 s, p = 0.07). Pre-treatment with TENS produces a significant improvement in exercise tolerance and measures of ischaemia but not significant improvement in symptoms.

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