Cardiac shock wave therapy - a new method for treatment of advanced coronary disease and refractory angina

Despite continuous progress in pharmacological management and development of myocardial revascularisation techniques, a significant number of patients with advanced ischemic heart disease and refractory angina pectoris cannot be treated successfully. For the group of patients with chronic refractory angina therapeutic options are, however, limited. Several alternative therapies, such as transmyocarclial laser revascularisation, transcutaneous electrical nerve stimulation or angiogenesis by gene or cell therapy have been clinically tested. This paper presents a new promising method, non-invasive cardiac shock wave therapy with a review of available clinical information on therapeutic potential in advanced ischemic heart disease and refractory angina treatment. The method is based on percutaneous application of low frequency ultrasound, i.e. mechanical shock waves with ECG gating. Therapeutic sessions are performed under echocardiographic monitoring. In the last thirty years the shock wave therapy has become a method efficiently employed in nephrology, gastroenterology, orthopedics, rehabilitation and dermatology, as well as pending confirmation through further research - cardiology.