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What is Enhanced external counterpulsation – EECP
A therapy for ANGINA PECTORIS that uses sequential inflation and deflation of cuffs on the legs and pelvis to assist in returning venous BLOOD to the HEART and decreasing cardiovascular resistance in the peripheral arteries. EECP reduces the heart’s workload during systole, when the ventricles contract, and increases pressure in the peripheral arterial network during diastole, when the ventricles fill. The net effect is that the body’s tissues, including the heart, receive more blood and thus more oxygen with less work from the heart.
Researchers arrived at the concept of EECP in the 1950s. Initial therapeutic efforts were invasive, withdrawing blood from the femoral veins and then returning it. Through the ensuing decades researchers arrived at the method of using compression cuffs around the calves, thighs, and pelvis, alternately inflating and deflating them in a sequence timed with the CARDIAC CYCLE. The cuffs inflate sequentially from the calves to the pelvis during diastole and deflate rapidly and simultaneously during systole. A computer monitors the cardiac cycle via ELECTROCARDIOGRAM (ECG) and coordinates the inflation and deflation of the cuffs accordingly. A therapeutic course involves one hour of EECP daily for 35 hours (typically five days a week for seven weeks), performed at a cardiac clinic or hospital. Most people experience relief from angina for months to 2 or 3 years.
EECP is most appropriate for people who are not receiving adequate relief from medications and would benefit from CORONARY ARTERY BYPASS GRAFT (CABG) but cannot, or choose not, to undergo the surgery. EECP is not appropriate for people who have uncontrolled HYPERTENSION or ARRHYTHMIAor who have bleeding disorders. There are no identified risks associated with EECP. Some people do find the pressure of the counterpulsations somewhat uncomfortable.