Enhanced external counterpulsation (EECP)
Enhanced external counterpulsation is a non-invasive out-patient treatment for heart disease and, in particular, for angina (chest pain due to an inadequate supply of oxygen to the heart muscle). EECP is designed to relieve angina by improving perfusion in areas of the heart deprived of an adequate blood supply. EECP uses a device to inflate and deflate a series of
compressive cuffs that are wrapped around the calves and lower and upper thighs. The basic principle involved is that of counterpulsation.
The cuffs inflate during diastole, the period when the heart muscle relaxes and the chambers fill with blood. The cuffs inflate sequentially from the calves upwards, resulting in increased pressure in the aorta and coronary arteries. Compression of the vascular bed in the legs also increases the return of venous blood to the heart and increases cardiac output. Patients are customarily treated with EECP for an hour a day for a total of 35 hours. See also: Counterpulsation.
How EECP works is not well understood. It is thought that EECP forces slightly more blood into the blood vessels supplying the heart. Over time, this causes more blood vessels to grow in the heart muscle. Because angina is caused by the heart muscle not getting enough blood, growth of more blood vessels helps relieve angina. EECP may also help by lowering blood pressure slightly .
Enhanced external counterpulsation is used to decrease pain from angina pectoris. Angina is chest pain or discomfort. It happens because the heart muscle doesn't get enough blood and oxygen for the work it's doing.
External counterpulsation improves the balance between the amount of oxygen the heart needs and the amount it gets. Both these changes reduce the pain of angina, increase level of exercise and decrease the need for medication.
Most people are treated for 1 hour per day, 5 days a week, for 7 weeks, but your health care provider may change this plan. You lie on a table with a blood pressure cuff wrapped around each calf, and 2 cuffs placed around each thigh. The cuffs are connected to a device that inflates and deflates the cuffs, starting with the calf and moving upward with each heart beat. The procedure should not be painful.