EECP Therapy

WHAT IS EECP Therapy?

Enhanced external counter pulsation (EECP) is an outpatient nonpharmacologic and noninvasive therapy, involving the use of electrocardiogram-synchronized inflatable cuffs wrapped around the lower extremities to produce cyclic inflation and deflation.

It applies sequential external pressure to the lower extremities at the end of systole to increase diastolic coronary perfusion pressure and venous return.

The result is improved circulation in the coronary arteries and an increase in the amount of blood pumping by the heart to all the organs and tissues of the body.

This safe and effective approach stands as an alternative to invasive procedures like angioplasty and bypass surgery, often serving as a complementary treatment alongside medication and lifestyle adjustments.

WHAT ARE THE EFFECTS AND BENEFITS OF EECP?

Increase the amount of blood flow in the coronary arteries
Increase the blood flow velocity in the coronary arteries.
Decrease the systolic blood pressure (less resistance of the heart to pump blood).
Increase the diastolic blood pressure (better perfusion in the coronary arteries).
Raise the amount of blood pumped out of the heart's left ventricle with each beat (ejection fraction).
Decrease the high blood pressure and the amount of force exerted on circulating blood by the vasculature of the body (systemic vascular resistance).
EECP therapy relieves the symptoms of angina pectoris and/or equivalent angina pectoris such as fatigue, tiredness, shortness of breath, palpitations, or lack of energy by improving the flow of blood to the heart muscle (myocardial perfusion).
Diminish the need for medications such as nitrates for those with angina pectoris.
Reduce the process of atherosclerosis in the coronary arteries.
Improve exercise tolerance.
Better quality of life.

HOW IT WORKS?

EECP therapy enhances cardiac function by optimizing blood and oxygen supply to the heart muscle, reducing the heart's workload through sequential cuff inflation from the calves to the thighs and buttocks during the heart's resting phase. Just before the subsequent heartbeat, all cuffs simultaneously deflate, allowing blood to naturally divert away from arteries with significant plaque and favoring healthy, unobstructed vessels, ultimately forming lasting pathways for blood to reach the heart, resembling a "natural bypass."

WHAT TO EXPECT?

This is a brief step-by-step explanation of the EECP therapy procedure.

The patient lies on a comfortable bed with a series of pneumatic cuffs (similar to BP cuffs) wrapped around the calves, thighs, and buttocks.
Three electrodes are placed on the chest to monitor the heartbeats.
The cuffs will inflate and deflate in time with the patient’s heartbeats.
Cuff inflation occurs after each heartbeat—during diastole—squeezing the lower extremities and pushing the blood toward the heart. This increases the blood flow to the coronary arteries that provide much-needed oxygen and nourishment to the heart muscle.
Rapid cuff deflation occurs before the next heartbeat. This creates a void in the blood vessels of the lower extremities. This decreases the effort exerted by the heart when it contracts during systole.
Systolic and diastolic pressure changes are monitored by a sensor placed on one of the fingers for plethysmography recording. (See figure.)
Vital signs are obtained before and after each treatment.
The EECP therapist remains nearby to facilitate effective therapy and ensure patient comfort.

COMPARISON OF TREATMENTS OPTIONS

Coronary artery disease (CAD) is a condition characterized by chronic inflammation. The current treatment options for CAD include invasive procedures like percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). However, these procedures only aim to relieve the symptoms of the condition and do not offer a cure or prevent heart attacks. An effective, non-invasive alternative to these procedures is EECP.

EECP is performed in the comfort of a physician’s office and requires only one hour of the patient’s time.

EECP: A NATURAL BYPASS

During EECP, the blood flowing to your heart naturally bypass arteries with significant plaque and instead enter healthy, non-diseased blood vessels of small diameter, circumnavigating blockages. In time, these new pathways are reinforced and become lasting routes for blood to reach your heart beyond the blockages.

This is why EECP is often referred to as a “natural bypass.”

WHO IS A CANDIDATE FOR EECP? CURRENT INDICATIONS FOR HEART DISEASE:

Patients with coronary artery disease and angina pectoris.
Patients who are poor candidates for coronary angioplasty and stent deployment or who failed to this intervention.
Patients with symptomatic coronary artery disease are inoperable or at substantial risk for operative complications or postoperative failure.
Patients with angina who have undergone coronary artery bypass grafting and/or stent placement in the coronary arteries.
Patients who want to minimize their dependency on medications by improving blood flow and function of their hearts (“natural bypass”).
People who want to have the benefits of EECP treatment and to prevent possible health complications. (Acute coronary event, heart attack, stroke, etc.)
Patient with coronary artery bypass grafting (CABG) surgery, angina pectoris who is not a candidate for a second operation or PCI.

MAIN CONTRAINDICATIONS

Patients considering EECP should undergo a through medical evaluation to assess their suitability for this therapy and to identify any potential contraindications or precautions.

The following are contraindications to the use of EECP:

Acute decompensated heart failure
Recent myocardial infarction within the last 2 weeks
Unstable angina pectoris
Severe hypertension > 180/110 mm Hg
Coagulopathy with international normalized ratio of prothrombin time > 2.0
Severe aortic regurgitation
Abdominal aortic aneurysm (>5 cm) or dissection
Arrhythmias that may interfere with triggering of EECP system (uncontrolled atrial fibrillation, flutter, and very frequent premature ventricular contractions)
Heart rate of <35 or >125 beats per minute
Any surgical intervention within 6 weeks before EECP
Recent cardiac catheterization (1–2 weeks) or arterial femoral puncture
Severe peripheral arterial disease with non-healing wounds or gangrene
Severe venous disease (thrombophlebitis, prior or current deep vein thrombosis or pulmonary embolism)
Severe chronic obstructive pulmonary disease
Pregnancy or women of childbearing age who do not have a negative pregnancy test

EECP STANDARD PROTOCOL

EECP therapy for heart disease is usually prescribed by a cardiologist or cardiovascular surgeon.
The standard EECP treatment protocol consists of:

► One-hour session per day

► Five days a week, for seven consecutive weeks

► For a total of 35 treatment sessions

EECP has been proven to be a safe therapy, as reported by the International EECP Patient Registry.

EECP RISKS OR ADVERSE EFFECTS

Occasionally, some patients complain of mild skin abrasion, bruising, or blistering underneath the pneumatic cuffs.
To prevent these, the patient wear especial elastic pants and the EECP therapist will place extra padding where needed to make the patient comfortable.
Our rigorously trained and certified EECP therapists are committed to deliver exceptional care.

EECP THERAPY