What is enhanced external counterpulsation therapy (EECP)?

General responses to selected questions from Joel Braunstein, MD, of Johns Hopkins University and Joseph Toscano, MD.

Question:

I would like to thank you for your kind and valuable response about EECP. Sir may i know one more thing about EECP that is " may I know the success rate of EECP ? Does it have any kind of side effects or after affect and is the patient totally cured? I would be grateful to you if you can kindly clarify my query as my father is being adviced EECP.

Answer:

Thank you for your timely question. Enhanced external counterpulsation therapy (EECP) is an emerging and exciting approach to managing individuals with persistent symptoms of heart-related chest pain (angina), despite being on optimal medical therapy. EECP is a technique where pneumatic cuffs are wrapped around an individual's calves, lower thighs, and upper thighs. These cuffs inflate and deflate in synchrony with relaxation and contraction, respectively, of the heart. Each EECP treatment generally lasts one hour per day and is performed five days per week for a total of seven weeks. While EECP does not "cure" heart disease, multiple studies have clearly demonstrated that the treatment reduces angina symptoms, improves functional status, improves quality of life, and reduces individuals' reliance on other chest pain controlling medications, among other benefits.

Unfortunately, EECP is not indicated for everyone. Individuals with significant peripheral vascular disease, aortic aneurysm disease, or aortic valve leakage (aortic insufficiency or regurgitation) are not candidates for such therapy. For those in whom EECP is indicated, it portends a fairly high success rate. An estimated 80% of individuals experience at least some reduction in their chest pain frequency and severity.

In general, EECP is very well tolerated. Patients undergoing EECP equate the procedure with a deep massage. While there are no serious short or long-term risks associated with EECP, some patients may experience mild headaches, dizziness, fatigue, muscle aches, or mild skin irritation around the cuff sites.

Should your father decide to undergo treatment with EECP, I wish him luck and hope that it affords him the same benefits it has afforded to so many other individuals thus far.