‘An amazing relief’: implant offers hope for those with refractory angina

Study finds device brings significant fall in chest pain in 75% of patients, but further trials and NHS approval are needed

“It’s an amazing relief, both physically and emotionally, to be able to live my life again normally, without feeling that I’m limited all the time in what I can do.”

Cristian Jensen is describing the difference that an implant inserted in his chest – to reduce the symptoms of his debilitating angina – has had on his life.

The 64-year-old used to have five angina attacks a week, each involving a sharp, acute pain that reminded him of the heart attack he once had. Now he has an attack every week or two.

He used to have to limit the amount of exercise he did, in case strenuous activity induced an attack. Now he’s walking further and faster and no longer worries about climbing stairs.

“It’s made a huge difference to my confidence,” the packaging designer adds. “Angina is a reminder that something isn’t right with your body. It’s like a sharp pain in the middle of your chest that stops you doing what you are doing.

“The fear that the pain of an episode of angina could be a heart attack. Suddenly not having that anxiety at the back of your mind changes your life.”

Angina , a common form of heart disease, involves pain in the chest, neck, shoulders, jaw or arm.

Jensen had a long and troubled history of heart problems before consultant cardiologist Dr Ranil de Silva fitted him with the implant – a coronary sinus reducer (CSR) – at the Royal Brompton hospital, a renowned centre of specialist NHS heart and lung care in London, in 2021.

In 1990, he was diagnosed with angina at an unusually young age – at just 28 – after an angiogram showed he had blocked arteries.

Open heart surgery helped. “That fixed me, for a while at least,” he says. “I was angina-free for 17 years until I had a heart attack in 2007.” That led to him having the first of what became eight stents put in, to help his arteries stay open and his heart to keep pumping blood around his body.

But in 2015 he began taking drugs to lower the high level of bad cholesterol in his bloodstream – fatty deposits that narrow the arteries. He also started using another drug, a spray called gylceryl trinitrate (GTN), to banish the pain each of his angina attacks brought.

Jensen is one of an estimated 300,000 people in England with refractory angina. That is angina that remains problematic despite the patient having drugs, stents and heart bypass surgery.

When Jensen’s symptoms persisted, de Silva suggested he have the implant fitted. Despite the large number of people with the condition, only a handful have had what is still an experimental treatment.