If you suffer from chronic angina pectoris or congestive heart failure, your physician may consider you a candidate for EECP (Enhanced External Counterpulsation). This is an outpatient therapy option for the treatment of diseases of the cardiovascular system in cases of angina, congestive heart failure, cardiogenic shock and acute myocardial infarction. The therapy increases circulation in areas of the heart with less than adequate blood supply and may restore systemic vascular function. A study published in the American Journal of Cardiology suggests that EECP may be an appropriate treatment option for patients with symptomatic coronary artery disease who would otherwise be referred for percutaneous coronary interventions such as balloon angioplasty or intracoronary stent placement. Ozlem Soran, M.D., Assistant Professor in Medicine at the Cardiovascular Institute University of Pittsburgh and a co-author of the study, commented, “Despite some of the limitations inherent in this analysis, these and other recent data suggest that perhaps we need to re-examine our treatment algorithm for symptomatic coronary artery disease patients and opt for EECP first in select patient subsets rather than using EECP as a last resort strategy.” Dr. Soran continued, “Based on our experience with EECP to date, I believe there are many angina patients who would consider having EECP if it meant that they could avoid or at least defer having a more invasive procedure performed. This is analogous to the current situation in which some patients who are eligible for both PCI and bypass surgery opting to have a less invasive catheter-based procedure first despite the fact that surgery may provide more effective long-term relief of symptoms.” One of the first patients to receive the EECP treatments at Northwest Arkansas Heart and Vascular Center was eager to have the treatments recalling his positive experience with EECP two years ago in Little Rock. He completed the program in August 2002 and stated, “I now have more energy than I had and my family tells me that my color is better than it had been. I would recommend that anyone who is a candidate for EECP take the treatments, as their blood circulation will be improved. I have met people who were not expected to live and the EECP treatments have extended their lives.” Another patient who received the EECP treatments at NWA Heart & Vascular Center stated, “Before EECP, I was weak, unable to walk any distance, passing out, short of breath, unable to drive and had to stop dancing. After ten days of treatment, I could tell a big improvement. I now have good strength, can breathe better, can walk, drive, work in the yard and mow my lawn. I am not passing out, circulation is better and my eye sight is better.” While EECP is performed, the patient will lie on a bed wearing a series of pressure cuffs (like larger blood pressure cuffs) around the calves, lower thighs and upper thighs. The EECP system includes a pressure source that inflates and deflates these cuffs. The pressure moves the blood from the lower limbs toward the heart. The vascular networks in the large muscles of the legs are compressed in sequence, progressing from the calves upward. Each wave of pressure is electronically synchronized with your heartbeat via an electrocardiographic signal, so that the increased blood flow is delivered to the heart at the precise moment it is relaxing and blood flow through the coronary vessels is at its peak. When the heart pumps again, the pressure in the cuffs is withdrawn and the cuffs are deflated instantaneously. This lowers resistance in the vascular bed of the legs so that blood may be pumped more easily from the heart. EECP can have a range of benefits depending upon the individual patient. Most patients suffering from chronic disabling angina pectoris have experienced relief of pain associated with this condition after a full course of treatment. In a study of patients with chronic disabling angina, all experienced substantial relief of anginal symptoms after treatment with EECP. Typical benefits for patients might include decrease in chest pain, reduction in the use of medication and ability to enjoy a more independently mobile and active lifestyle. While it is not expected that everyone suffering from chronic angina pectoris will experience the same level of improvement, it does appear that EECP is an effective therapy for many angina patients. Because each individual’s condition is unique, there is no specific time when you can expect to feel an improvement. Experience has shown; however, that patients tend to report some improvement in their condition after as few as 10 or 12 treatment sessions, although others do require longer. Treatment with EECP involves a series of 35 one-hour sessions over a period of approximately seven weeks. People who think they may benefit from EECP therapy should
discuss the possibility of having the therapy with their physician.
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