Zeitschrift für Kardiologie
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Patients with therapeutically refractory angina pectoris do not respond to adequate anti-anginal medication and are not suitable anymore for revascularisation procedures. This group of patients has a poor quality of life, since their exercise capacity is severely afflicted. A new additional therapy for patients with refractory angina is neurostimulation. ⋯ The mechanisms of action of SCS are unclear, although there is evidence of an increase in myocardial oxygen supply, as is shown in peripheral vascular disease. Sympathetic nervous activity, prostaglandins, and endogenous opiates may also play a role in pain suppression by SCS. As soon as the safety and the complication rate are established, SCS may be commonly used as an additional therapy in patients with so-called "intractable angina pectoris".