Enhanced External Counter Pulsation is referred as EECP is one of the comprehensive alternative to Bypass Surgery to treat heart blockages. This is a Non-Surgical treatment for patients with blockage in blood vessel carrying blood to heart muscles (coronary arteries). The treatment works by improving the blood supply to heart muscle beyond the blocked artery by promoting new vessel formation across the blocked arteries and also by enhancing collateral circulation. In simple word EECP, is called as “Natural Bypass” as its establish blood flow across the blocked arteries naturally by enhancing the alternative channel of blood flow. This alternative channels naturally exist in our heart and only need some pressure to open it. EECP treatment exactly does this only.
This one of the potential alternative therapies to treat heart blockages consists of one hour day of 35 consecutive days.
During a typical EECP one hour treatment session, patient lie on a special treatment bed wearing a series of adjustable cuffs around your legs. The cuffs inflate and deflate in perfect synchronization with patients own heart beat with microsecond precision.
Blood is pushed back with precise timing in sequential pulsatile compression from the legs towards the heart increasing the blood flow to heart muscles by forming new vessels. Then receive the blood towards the leg by deflating the cuffs when the heart pumps out thereby decreasing the heart workload. All these are done when the patient is relaxed and blissfully unaware of the significant change in blood flow occurring to their heart.
In just 2 weeks time patients endurance and exercise ability greatly enhanced and their cardiac symptoms like chest pain, shortness of breath, inability to do their routine activity improves. Patient frequent medications like nitrate taken for chest pain is reduced or can be even stopped. The treatment benefit has shown to last up to five years and more.
The treatment is cleared by US FDA and also it is in the recommendation of American heart association and European society of cardiology guidelines of treating heart disease.
The treatment has also been shown to positively reduce heart rate, decrease hypertension, blood sugar level and improve renal function.
External counter pulsation (ECP), also referred to as enhanced external counter pulsation (EECP), is a technique that increases arterial blood pressure and retrograde aortic blood flow during diastole (diastolic augmentation). Cuffs are wrapped around the patient’s calves, thighs, and pelvis and, using compressed air, sequential pressure (up to 300 mmHg) is applied in early diastole to propel blood back to the heart.
The efficacy of ECP was evaluated in the MUST-EECP trial, which randomly assigned 139 outpatients with angina, documented coronary artery disease, and a positive exercise tolerance test to 35 hours of active EECP using a cuff pressure of 300 mmHg or inactive counter pulsation using a cuff pressure of 75 mmHg over a four- to seven-week period of time. The following results were seen:
- Active EECP was well tolerated without limiting side effects.
- Exercise duration increased to a similar degree in both the active and inactive EECP groups; there was also no significant difference in nitroglycerin use.
- Patients undergoing active EECP had a significant increase in time to ≥1 mm ST segment depression compared to baseline (379 versus 337 seconds), while there was no change in the inactive group.
- More patients undergoing active EECP had a decrease in anginal episodes and fewer had an increase in angina compared to the inactive group.
