Document Detail


Thoracic spinal cord stimulation for post-ablation cardiac pain in a patient with permanent pacemaker.
MedLine Citation:
PMID:  18366466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spinal cord stimulation (SCS) is increasingly utilized for inoperable, intractable chest pain because of ischemia. Because patients with ischemic heart disease commonly have permanent cardiac pacemakers (PPM) or automated implantable cardio-defibrillators (AICD), concurrent use of SCS and PPM or AICD may grow. Interference between SCS and PPM or AICD devices is potentially dangerous and has been previously reported. CASE REPORT: A 51-year-old woman who underwent multiple catheter-based cardiac ablations for a variety of tachy-atrial arrhythmias. These procedures included atrioventricular node destruction, which left her PPM-dependent (third degree heart block with an intrinsic heart rate in the 30s). During the course of her cardiac treatment, she developed chest pain which was not amenable to cardiac intervention and was refractory to medical management. The patient was evaluated for consideration of SCS and ultimately underwent implantation. Procedures evaluating SCS-PPM compatibility were followed and are described. Immediately after SCS implantation and at 6 months follow-up, the patient experienced improved pain relief. DISCUSSION: Others have reported SCS implantation in patients with PPM. This is the first report to describe safe and effective use of an Advanced Bionics SCS in a patient with a Guidant PPM. In addition, we speculate that this patient's cardiac pain may have been other than ischemic in origin. As such, this case may represent a unique clinical scenario. Despite many cases series and case reports demonstrating safety of concurrent SCS and PPM or AICD, the complexity of these technologies requires continued demonstration of device compatibility in novel contexts.
Authors:
Bryan C Hoelzer; Abram H Burgher; Marc A Huntoon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pain practice : the official journal of World Institute of Pain     Volume:  8     ISSN:  1533-2500     ISO Abbreviation:  Pain Pract     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130835     Medline TA:  Pain Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  110-3     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Mayo Clinic College of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. hoelzer.bryan@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Chest Pain / etiology*,  therapy*
Electric Stimulation / methods*
Female
Follow-Up Studies
Humans
Middle Aged
Pacemaker, Artificial / adverse effects*
Spinal Cord / physiology*,  radiation effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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