RESUMEN
Orthostatic hypotension is a complex medical problem with various underlying pathogenic mechanisms and limited modalities for its correction. Since transcutaneous spinal cord stimulation (t-SCS) leads to immediate blood pressure (BP) elevation in a supine position, we suggested that t-SCS may attenuate blood pressure drops in orthostasis. We aimed to evaluate the hemodynamic effects of t-SCS during tilt testing in a feasibility study in three patients with documented orthostatic hypotension. Four sessions on two different days of tilt testing on and off t-SCS were performed on each patient. While tilting with t-SCS off showed typical significant BP drops in every patient, active t-SCS resulted in systemic vascular resistance (SVR) elevation in all patients and significantly higher values of systolic and diastolic BP in two patients. T-SCS requires further investigation on a larger patient population. However, our preliminary results demonstrate its ability for SVR and BP elevation in subjects with severe orthostatic hypotension.
RESUMEN
We aimed to determine if non-invasive electrical spinal cord stimulation (NIE-SCS) is associated with acute changes in systemic and pulmonary hemodynamics and cardiac electrophysiology at rest. Nine subjects without structural heart disease referred for catheter ablation of cardiac arrhythmia were included. NIE-SCS was performed in each patient at vertebral levels T1, T7, and T11. Higher systolic BP (BPs) was detected during T1 NIE-SCS as compared with baseline (147.9 ± 22.5 vs 135.4 ± 17.4 mmHg; P = 0.02). Atrioventricular nodal effective refractory period (AVN ERP) was shorter during stimulation at T1 and T7, when compared with baseline values (baseline 303.3 ± 15.0 vs 272.0 ± 19.2 for T1 vs 278.0 ± 8.3 ms for T7; P < 0.05). NIE-SCS at the T1 level is associated with an elevation of BPs. NIE-SCS at the T1 and T7 levels shortens AVN ERP. Further studies are needed for the evaluation of chronic effects.