Enhanced External Counterpulsation: A Patient Guide

What is enhanced external counterpulsation?

Enhanced External Counterpulsation (EECP) is a treatment for angina (also called angina pectoris), or chest pain. Angina occurs when the muscle cells of the heart do not get enough blood to properly maintain their pumping function. The lack of blood supply is most likely to cause pain during physical activity, when the heart pumps fastest and needs the most oxygen. In most people, angina is caused by coronary artery disease.

Results of clinical trials show that EECP is a safe and effective choice for people who are considered at high risk for bypass surgery and angioplasty. The procedure is administered in an outpatient setting, does not require any surgery or anesthetic, and is relatively comfortable for patients.

When applied over time, EECP can reduce the frequency of angina episodes, improve exercise capacity, and may even reduce the need for medications. EECP is not meant to replace bypass surgery or angioplasty, but is an additional treatment for those patients who can no longer benefit from additional surgery or angioplasty.

How does EECP work?

EECP enhances blood flow to the heart and coronary arteries by squeezing blood out of the lower parts of the body up towards the heart. Sometimes referred to as a "natural bypass," EECP stimulates the growth of new blood vessels around blocked arteries.

While EECP is performed, you will be lying on a special treatment table wrapped in three sets of cuffs (like large blood pressure cuffs) around your calves, lower thighs and upper thighs (including the buttocks). The EECP treatment system includes an air compressor that inflates and deflates these cuffs, starting with the calf cuffs, then the lower thigh cuffs, and then the cuffs at the upper thigh and buttocks.

The pressure moves the blood from your lower limbs toward your heart. Each wave of pressure is timed to your heartbeat so that the increased blood flow is delivered to your heart at the time that it is relaxed and blood flow to the heart arteries is at its peak. When the heart pumps again, all the cuffs deflate at the same time. This lowers the resistance in the blood vessels of your legs, and decreases the amount of work for your heart to pump blood to your body.

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