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ngina pectoris in patients with ischaemic heart disease is usually treated successfully with anti-ischaemic drugs and percutaneous or surgical coronary interventions. In some patients, however, angina attacks are not pre-vented by optimal medical treatment and coronary lesions are judged unsuitable for coronary revas-cularisation. These patients with refractory angina have recurrent, disabling symptoms, which mark-edly limit daily activities. The precise prevalence of refractory angina is not known. However, the number of patients with angina not suitable for coronary interventions is likely to increase in the future, in particular, because of the prolonged survival of patients wit