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What is External Counterpulsation (ECP)?
External Counterpulsation (ECP), commonly referred as enhanced external counterpulsation (EECP), is a noninvasive outpatient procedure approved by the US FDA for the treatment of angina pectoris, acute myocardial infarction, cardiogenic shock and congestive heart failure (CHF). Patients usually receive treatment for 1 or 2 hours a day for 35 hours, and the treatment is reimbursed by Medicare and most insurance companies.
How Does ECP Work?
At the start of diastole, pressure is applied sequentially through cuffs wrapped on a patient's calves, thighs and buttocks. At the end of the diastolic cycle, pressure in all three cuffs is released simultaneously. Such finely timed repeating pressurization process leads to increased diastolic pressure, increased venous return, and systolic unloading which results in increased cardiac output and coronary perfusion.
Published studies have shown that the increased blood flow to the heart forces blood through stenosed vessels and facilitates the development of collateral circulation or "natural bypass" of the blocked arteries through the growth of new blood vessels. It is believed that the mechanism is mediated through the release of angiogenesis growth factors stimulated by the shearing effect on the lining of the coronary arteries produced by increased blood flow during ECP therapy.
What Can One Gain From ECP?
Clinical studies in the US and abroad have demonstrated the following benefits in patients presenting with angina:
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2/3 of patients with severe angina
improve with treatment
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65% of patients with Canadian Class 3 or
4 improved at least one class.
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Increased time to exercise-induced ST depression.
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Increased exercise tolerance.
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Improved quality of life.
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Decreased episodes of angina, decreased use of nitrates.
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Increased myocardial perfusion with nuclear imaging.
ECP is an excellent treatment modality with
advantages such as:
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ECP is the only noninvasive treatment for coronary artery stenosis.
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ECP is an outpatient treatment.
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ECP is safe, painless and relatively comfortable.
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No life threatening complications.
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1/5 of the cost of PTCA. 1/10 of the cost of CABG.
Contraindications
Patients generally not eligible for treatment are:
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Those with atrial fibrillation or other serious arrhythmias
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Use of Coumadin or another anticoagulant
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Bleeding diathesis
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Aortic valve insufficiency
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Active thrombophlebitis
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Severe lower extremity vaso-occlusive disease
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Recent cardiac catheterization
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Aortic aneurysm requiring surgical repair
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Uncontrolled severe high blood pressure or rapid heart rate
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Pregnancy
Please consult with your doctor about ECP treatment for your condition.
Where to Know More about ECP?
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