Enhanced External Counter Pulsation (EECP) is performed as a non-invasive treatment to lower the number and intensity of angina episodes. Treatment is administered through three pairs of external inflatable cuffs that are applied around the lower legs, upper legs and buttocks. These cuffs continuously inflate and deflate between the resting period of the heartbeat and increase blood returned to the heart.

The basic principle of EECP treatment involves increasing the amount of blood returning to the heart, which helps supply more oxygen to its starved areas. With more oxygen available, the heart can function much more efficiently and therefore reduce chest pain.

History of EECP Treatment

EECP treatment originated in China where it has been extensively used since the 1960s. In the past 10 years it has been introduced to the United States, where there are currently around 1200 machines in operation. The idea for EECP stemmed from the development of the intra-aortic balloon pump (IABP). IABP resulted in increasing the amount of blood that can get pumped out of the heart by inflating a balloon in the aorta between each heartbeat. Opening up the aorta allows more blood flow and therefore decreases how hard the heart has to work. This same theory is applied to EECP but is taken one step further. EECP Increases the amount of blood going back to the heart, providing more blood for the heart to work with. This also decreases how hard the heart has to work but on a much greater scale, especially for people with damaged heart tissue.

Who Is Eligible for EECP Treatment?

Individuals are eligible for treatment if they have:

  • Had coronary artery bypass (CABG) or stents placed in the coronary arteries with ongoing angina.
  • Had no prior bypass or stenting but continue to suffer from angina

Who Should Not Seek EECP Treatment?

Patients who should not undergo EECP include those with:

  • Hypertrophic cardiomyopathy
  • Congenital heart disease
  • Valvular disease
  • Enlarged heart
  • Pacemaker
  • Hemorrhage
  • Atrial fibrillation (Afib)
  • Pulmonary hypertension
  • Clot in their body
  • Peripheral artery disease (PAD), also called peripheral vascular disease (PVD)
  • Severe elevated blood pressure
  • Heart rate greater than 120 beats per minute

What Are the Benefits of EECP Treatment?

  • Increased oxygen supply for the heart
  • Decrease in chest pain
  • Improved EKG response to exercise
  • Decrease in nitroglycerin use
  • Increase in energy
  • Increased exercise duration
  • Long term effects up to 2 years

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