EECP (Enhanced External Counter Pulsation)

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Things you need to know about EECP

Blocking in the coronary arteries carrying the blood supply to the heart can lead to disabling and severe chest pain, shortness of breath at rest and and more on walking and tiredness. Physicians usually treat coronary artery blockage by medicine, angioplasty, stent or bypass surgery. Despite these therapeutic advances certain problems in the treatment of chest pain persist. Drugs do not always provide relief and invasive procedures have their own associated risks. Many a time the blood flow which is restored across the blocked arteries may fail again causing angina.

The searches for effective treatment, which can increase the blood flow again by alternative pathway, decreases the chest pain and improve the quality of life without complicated invasive procedures, has yielded the new treatment called Enhanced External Counter Pulsation (EECP). This is the only non-invasive, non- pharmaceutical treatment approved by USFDA.

What is EECP?

EECP is an outpatient treatment for patients suffering from chest pain and poor heart function. During the treatment the patient lies on a comfortable with large BP machine-like cuff wrapped around his/her legs and buttocks. These cuffs inflate and deflate at specific times between patient’s heart beats.

A continuous electrocardiogram (ECG) is used to set the timing so the cuffs inflate while the heart is at rest, when it normally gets its supply of blood and oxygen. The cuffs deflate at the end of the rest heartbeat. The special sensor applied to your finger checks the oxygen level in your blood and monitors the pressure waves created by the cuff inflations and deflation.

EECP develops new pathways around blocked arteries in the heart by expending networks of tiny blood vessels (“capillaries”) that helps increase and normalize blood flow to the heart muscle.

What is Collateral circulation?

Formation of network of tiny blood vessels which make it possible for blood to detour around blocked vessel or narrowed arteries is called collateral circulation. However the development of collateral circulation is a gradual process and not everyone has the same ability to develop these networks at the rates that will relieve enigma. EECP treatment triggers and accelerates this collateral circulation and makes it permanent.

What are the advantages of the EECP Therapy?

EECP is non-invasive, simple, safe, risk free and cost effective treatment without surgery or hospital stay. Patient can take this treatment without treatment without disturbing his/her daily routine life.

How do I personally know the treatment has helped me?

  • Patient can walk more distances without chest pain
  • Patient would have fewer or no angina
  • Episodes of angina would be less painful
  • Patient’s need for anti- anginal medication can be reduced
  • Patients can return to work and can participate in their active life style once again
  • Patient would be more energetic

How long does EECP treatment take?

EECP involves 35 days of treatment session is for 1hour and the patient are asked to come six days a week for six weeks. Missed treatments can be adjusted and there by complete the course of 35 treatment session.

What does EECP do?

EECP causes immediate and sustained increase in heart’s blood supply by:

  • Dilating coronary blood vessels
  • Opening dormant (unused) capillaries
  • Forming new blood vessels (angiogenesis)

Is EECP treatment comfortable?

There is a feeling of pressure from the cuffs around your legs and buttocks. It is like being tightly hugged by the cuffs. Ones you become accustomed this pressure, the sessions but this usually pass comfortably.

What are the risks of EECP Therapy?

Occasionally, patients develop mild skin irritation in areas under the treatment cuffs or experience muscle or joint discomfort. Some patients feel tired after the first view session but this usually ends after the first week.

What should I do after the EECP Treatment?

To prevent the progress of your disease after completion of the treatment you should make life style changes likes:

  • Quit smoking
  • Control obesity
  • Do regular exercise
  • Follow Heart friendly diet

Have regular follow-up with your cardiologist to lower your cholesterol, to control your blood pressure and diabetes. EECP treatment provides you new vessels. It is up to you to prevent your vessels from developing obstructions.

When can I start feeling better from EECP?

Most of the patients begin feeling the clinical improvement from EECP between 15th to 20th sessions. These benefits include increase in overall energy level, decrease in angina or breath, completely stopping or decreasing nitroglycerin.

Is EECP a replacement for Bypass Surgery or Angioplasty?

Although EECP is not considered a replacement for coronary artery bypass surgery or angioplasty EECP will re-establish the coronary blood flow to render them unnecessary with improved collateral flow (natural bypass). EECP is also used in patients who already undergone surgery or angioplasty but not getting sufficient relief of their symptoms.

Does EECP give symptom relief as Bypass and Angioplasty?

All these current mode of treatment help the heart by increasing the blood flow to the area of the heart muscle not receiving adequate blood supply. Once the blood supply is increased towards normal the patient’s chest pain will be decreased or eliminated and his exercise tolerance will improve.

During EECP hearts natural mechanism of forming new vessel is enhanced which markedly increase the blood supply to the heart muscle. EECP also tends to improve your endothelial cell function of your coronary arteries.

The blood flow of the heart muscles is not proportionate to the degree of narrowing in a coronary artery. Angiography is done to see the narrowing in only large coronary vessels. It is extremely suitable to identify stenosis, which is essential for Angioplasty and Bypass surgery. However angiography cannot visualize small arteries like arterioles and capillaries and cannot assess overall blood flow in a particular area of heart.

Can EECP dislodge plaque and cause a stroke or heart attack?

No. Our bodies obey the law of Physics, and one principal law is that fluid will follow the path of least resistance. Atherosclerotic plaques are calcified and hard, and they create an obstruction that detours the blood through alternate routes. During EECP, when your blood is flowing to your heart it will naturally bypass arteries with plaque and enter healthy, non-diseased blood vessels to go around the blockages. Going around the blockages is a longer trip, but it is much easier one. In time, these new pathways are reinforced and become lasting routes for blood to reach your heart beyond the blockages. Every EECP patient has had multiple, serious blockages. No one ever had a heart attack or a stroke as a result of the treatment.

Is EECP a recognized treatment?

EECP is internationally recognized by FDA (USA), CE mark (Europe) etc.

EECP is mentioned in medical textbooks. Many articles have been published in the journal of the American Collage of Cardiology, Cardiovascular Reviews Reports, Proceedings of Mayo clinic, Journal of External Counter Pulsation, etc.

EECP is now provided world-wide by leading hospitals. The success of EECP can be judged by the fact that in the US Medicare reimbursement rate for EECP has increased by 7% whereas that for other procedures like angioplasty and bypass surgery decreased by 6%.

The international EECP patient Registry (IEPR) collets data on safety, effectiveness and long –term benefits of EECP therapy can last up to 5 years after completing the first course (35hours) of treatment.

EECP Treatment – Clinical Summary

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