What is EECP?
Enhanced External Counter-pulsation (EECP) is a non-surgical therapy for angina, Heart disease, high blood pressure, and other conditions involving poor circulation. EECP is a mechanical procedure in which long inflatable cuffs (like blood pressure cuffs) are wrapped around both of the patient’s legs. EECP has two potentially beneficial actions on the heart. EECP, effectively, “pumps” blood into the coronary arteries. Second, by its deflating action just as the heart begins to beat, EECP creates something like a sudden vacuum in the arteries. The EECP pumping console then rapidly inflates and deflates the leg cuffs in time with the heartbeat.
EECP : A Non-Invasive, Outpatient Treatment
Unlike procedures such as bypass surgery, balloon angioplasty, and stents, EECP is entirely non-invasive (involves no surgery, drugs or needles), carries no risk, is comfortable, and is administered in an outpatient setting. In fact, EECP can feel like a deep muscle massage to the legs and the patient is completely relaxed during the process.
EECP is administered as an out-patient procedure, making it very convenient for the patient and the family. The EECP pumping console then rapidly inflates and deflates the leg cuffs in time with the heartbeat.
EECP will benefit whom?
Nearly everyone with coronary artery disease can benefit from EECP. EECP is particularly well-suited to people who:
- Have already had angioplasty, stents or bypass surgery, and the heart disease symptoms have returned.
- Are not candidates for surgery due to other serious medical conditions.
- Do not want to undergo surgery or angioplasty.
- Rely heavily on medicines, or have to curtail their activities to avoid angina and other heart disease symptoms.
- EECP treatment may be the only way to obtain relieve from crippling angina.
What is Angina?
Angina pectoris literally means, ‘strangling in the chest’. It is the most common symptoms of coronary artery disease. The majority of patients with Angina complain of chest discomfort provoked by mental, physical or emotional stress. The discomfort can vary widely among patients who report shortness of breath, fatigue, indigestion, faintness, pain in the chest, arm, neck, or jaw and other symptoms.
What causes Angina?
Angina signals that a part of the heart muscle is not receiving an adequate supply of blood and oxygen. The heart requires a particularly rich blood supply because of its heavy workload, and receives this nourishing blood supply through the coronary arteries. When narrowed or blocked arteries restrict blood flow, oxygen supply to portions of the heart may at times be insufficient. Increase in oxygen demand can occur during exercise, fever, rise in emotion, periods of hypoglycemia, or after meals, triggering the onset of Angina.
How does Angina affect people?
Angina often occurs when exertion outstrips the ability of narrowed or blocked coronary arteries to supply blood to the heart muscle. Angina restricts activity for many patients.
They are able to walk, but not uphill nor while carrying packages. For some, Angina is disabling as it interferes with their ability to work or engage in almost any activity.
Is there any comparison of ECP treatment with other interventional treatments like Bypass and angioplasty?
Even though the patients treated with ECP are sicker group when compare to the patient undergone interventional procedures the results are comparable in spite of the disparity of risk profile in the two groups.
The 5-year survivals of ECP patients are 88% similar to the results seen in contemporary Bypass and angioplasty trail. (April 2000 clinical cardiology). Study comparing two ECP registries at Pittsburgh and Angioplasty registry at National heart lung and Blood institute (American Journal of Cardiology 2002 may 15th issue) shows the 1-year survival and adverse events results are comparable. But 17.2% of angioplasty patients went for repeat angioplasty procedure while only 6.3 % of ECP patients underwent repeats ECP. Also twice the no of patients in Angioplasty group reported to use Short time nitroglycerin when compare to ECP group.
How popular is this Treatment?
In USA 1996 ECP got FDA cleared and 1999 Medicare Insurance coverage. Leading Cardiology centers like Mayo clinic and Cleveland clinic has ECP center. In India after the company launched ECP a year ago now there are six centers and By 2006 there are approximately 2000 ECP systems installed worldwide.