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Enhanced External Counter Pulsation

What is it? 

  • It is a non-invasive outpatient therapy performed over several sessions to help patients with angina.

  • EECP is for patients who have persistent anginal symptoms and are severely functionally restricted, having exhausted the standard treatments for revascularization. EECP may stimulate the openings or formation of collaterals (small branches of blood vessels) to create a natural bypass around narrowed or blocked arteries.

Who is it for?

  • Patients who have chronic stable angina.

  • There is not adequate relief from angina by taking nitrates.

  • Patient does not qualify as a candidate for invasive procedures (bypass surgery, angioplasty or stenting).

How is it done?

  • Patients lie down on a padded table in a treatment room.

  • Three electrodes are applied to the skin of the chest and connected to an electrocardiograph (ECG) machine. The ECG will display the heart's rhythm during treatment. Blood pressure is also monitored.

  • A set of cuffs is wrapped around the calves, thighs and buttocks. These cuffs attach to air hoses that connect to valves that inflate and deflate the cuffs. Patients experience a sensation of a strong "hug" moving upward from calves to thighs to buttocks during inflation, followed by the rapid release of pressure on deflation. Inflation and deflation are electronically synchronized with the heartbeat and blood pressure using the ECG and blood pressure monitors.

  • Patients who are accepted for treatment must undergo 35 hours of EECP therapy. Treatment is typically administered 1-2 hours a day, five days a week, for 7 weeks.

How does it work?

  • The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to the heart. Each wave of pressure is electronically timed to the heartbeat, so that the increased blood flow is delivered to the heart at the precise moment it is relaxing. When the heart pumps again, pressure is released instantaneously. This lowers resistance in the blood vessels of the legs so that blood may be pumped more easily from the heart.

  • EECP may encourage blood vessels to open small channels that become extra branches. These channels or collaterals may eventually become "natural bypass" vessels to provide blood flow to heart muscle. This contributes to the relief of angina symptoms.

  • Published studies conducted at numerous medical centers have demonstrated benefits for most patients including:

                      - Less need for antianginal medication.

                      - Decrease in symptoms of angina.

                      - Increased ability to do activities without onset of symptoms.

                      - Ability to return to enjoyable activities.

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