A patient with chronic refractory angina often has a poor quality of life.
(1) presence of angina secondary to coronary artery disease
(2) chronic (> 3 months)
(3) often unremitting symptoms
(4) refractory to all therapeutic modalities (any combination of medical therapy, angioplasty and/or bypass surgery) or unable to undergo further therapy
(5) exclusion of noncardiac causes of pain
(1) Class III or IV in the Canadian Cardiovascular Society classification with significant impairment
(2) poor general health status
(3) poor psychological status (distress, depression, etc)
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