Enhanced External Counter Pulsation (EECP)
Introduction to EECP Enhanced External Counter Pulsation (EECP) is a non-invasive medical therapy that aims to reduce the pain and intensity of angina episodes (chest pain - notifying the body that the cardiac muscles aren’t receiving enough oxygenated blood). When heart patients ailing from angina don’t qualify for surgery or catheter-based coronary stenting, their doctor may recommend this treatment.
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How does it work ? The basic principle of EECP treatment involves increasing the blood flow to the heart, which increases oxygen supply to the areas that need it. When the heart gets sufficient oxygen, it functions more efficiently and thereby reducing chest pain.
The treatment begins when expandable cuffs are wrapped externally around the lower legs, upper legs and buttocks. Inflation and deflation of the cuffs alternate between when the heart is resting and pumping. This is regulated by a computer, which uses the patient’s electrocardiogram (ECG) to trigger inflation early in diastole (when the heart relaxes and is filled with blood), and deflation just as systole (heart contraction) begins. www.cardium.in
Is it an Alternative to Bypass Surgery ? Based on current research, patients who are eligible for this treatment include those who have undergone coronary artery bypass or stents placed in the coronary arteries with ongoing angina or those who cannot get bypass or stents but suffer from angina. This treatment is only approved as a last resort when all other medical options are exhausted. When patients begin this therapy a hormone called Vascular Endothelial Growth Factor (VEGF) is secreted and aids in the stimulation of the growth of new collaterals and improved arterial function. This hormone is required for angiogenesis, which forms new collaterals for blood to flow around blockages. Thus, it can be considered as ‘Natural Bypass surgery’. www.cardium.in
Benefits of EECP EECP differs from other medical procedures like bypass surgery, balloon angioplasty, and stenting as it is non-invasive, risk and sideeffect free, comfortable and is supervised in outpatient sessions. There are two principal benefits of EECP – 1. During diastole, the legs cuffs are pumped and thereby increases the flow of blood to coronary arteries. 2. During systole just before a heartbeat, a sudden vacuum is created in the arteries, which reduces the number of heart muscles required to pump blood. There are speculations of EECP reducing endothelial dysfunction as well. Another benefit includes the natural growth of new arteries for patients with heart disease or stroke. www.cardium.in
Risks of EECP EECP is a secure, competent and sanctioned medical treatment. Some patients do feel mild side effects like skin abrasion or bruising under the cuffs but these are rare and can be corrected by patients wearing special elastic pants or adding more padding to cuffs as deemed necessary for the comfort of patients by certified EECP therapists. However, there are certain standards for receiving this treatment and those who are not eligible for it include those who have : Recent cardiac catheterization, aortic insufficiency, irregular heart rhythm such as severe hypertension (high blood pressure), atrial fibrillation, peripheral artery disease involving the legs, hypertrophic cardiomyopathy, a congenital heart defect, valvular disease, enlarged heart, pulmonary hypertension, a pacemaker, heart rate over 120 beats per minute, history of deep venous thrombosis. The procedure is completely safe for everyone else. www.cardium.in
EECP is an angina treatment with a spotless safety record for more than twenty years now and its efficacy has been supported by many published researched more recently. The FDA has approved it as a treatment for chronic or unstable angina and for congestive heart failure. Patients have reported improved exercise tolerance and myocardial perfusion after successful completion of treatment and this evidence is backed by nuclear imaging and positron emission tomography. There is hope that continued research will shed additional light on the mechanism of action and confirm the lasting debilitation of symptoms in patients with unstable angina pectoris and congestive heart failure.
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