Enhanced Externaş Counter Pulsation(EECP)

EECP is used for treatment of heart failure and coronary artery disease (CAD), and as a preventive measure. It has beneficial effects on the heart, provides blood supply for many organs, and hence, serves to be an important treatment method. Preventing possible complications or delaying their occurence, EECP treatment prolongs life expectancy. EECP is an easy-to-apply, noninvasive treatment method without any serious side effects. It originated in China but now is used worldwide; in USA alone, over 1000 clinics apply this method. Since recent studies showed that EECP prevents atherosclerosis, also known as thickening of the arterial wall, it is currently used as a high-value treatment for CAD.

How To Perform EECP
During the treatment, the patient lies on his/her back with 3 couples of large cuffs wrapped around his/her calves, upper thighs and buttocks. These cuffs contain elastic bags which inflate at specific times. With the aid of the EECP monitor and an electrocardiogram (ECG) to set the timing, the cuffs inflate and deflate in between heartbeats. Treatments are usually given for an hour each day, for a total of 35 hours and given the patients do not experience severe side effects, do not require admission to the hospital. The patients can come to the hospital, receive their treatment, and afterwards, go on with their daily life. During EECP, patients do not feel any pain; they go through the process reading a book or the paper, or watching TV.

How EECP Works
As the cuffs wrapped below the waist inflate, pressure is applied on the blood vessels in the lower limb to increase blood flow to the heart. The arterial blood accumulating in the heart at a high pressure fills the coronary arteries to every extending branch. For example, when EECP is applied in an hourly basis and repeated 60-70 times for a total of 35 hours on a heart which beats 70 times a minute, coronary arteries filled with this high pressure blood eventually widen. EECP encourages blood vessels to open small channels that become extra branches called collaterals. These changes in the heart are referred to as “natural bypass” and “bloodless vascularization”.

The increase of bloodflow to the heart during EECP, strengthens myocardial contractions. As the cuffs deflate, the compression on the legs is withdrawn, preload is decreased and it is now easier for the heart to pump blood. This way, blood is supplied to less-perfused areas, patient is relieved of symptoms such as angina, dyspnea, and fatigue, drug-use is minimized, manpower is increased, overall improving the quality of a person’s life.

Changes in the blood endothelial lining during EECP prevent atherosclerosis. Cardiac patients who went through coronary artery bypass grafting (CABG) surgery, balloon angioplasty or stent implantation or who did not get any of these above-mentioned treatments, can all have EECP treatment which will in turn prevent further constriction and obstruction of blood vessels and the need for additional surgery. It will also prevent or delay the occurrence of serious conditions such as a heart attack, heart failure, and sudden death, eventually prolonging life expectancy.

Does EECP Have Unwanted Side Effects?
EECP is a safe and risk-free treatment without any side effects when applied by a competent and qualified physician.

Is EECP Contraindicated in Any Group of Patients?
It is contraindicated in patients who have severe valve disease especially aortic stenosis, aortic aneurysm, deep vein thrombosis (DVT), severe blood disorder especially clotting disorder, severe skin wounds in the lower limb, and in pregnant women.

When is EECP Performed?
Patients who have heart failure, hypertension and rhythm disorders first go through medical treatment until they’re stabilized. Patients who went through coronary angiography, balloon angiography or stent implantation need to wait 1-2 weeks. Patients who went thrıugh CABG or any other surgery, need to wait for 3 months. EECP can then be performed on such patients.

To Whom is EECP Applied and For What Purposes?
Patients who are diagnosed with heart failure receive EECP along with other types of treatments and in patients awaiting a transplant, EECP is used to render this waiting period as trouble-free as possible.

EECP is used in patients with CAD for treatment and prevention. Patients who have already had heart attacks and received some kind of an intervention either a balloon angioplasty or CABG, whose symptoms of angina and more do not regress despite medical treatment, and who can no longer have an additional surgery, namely patients with advanced CAD, do benefit from EECP. Hence, EECP is a good alternative for CAD patients devoid of other treatment options.

EECP proves to prevent the disease in patients with CAD who are currently symptom-free. Along the natural course of this disease, constrictions and obstructions in the coronary arteries ensue even after a successfull balloon angioplasty or CABG and this can lead to unwanted events such as a heart attack. The constrictions and obstructions appear on a shorter time and an increased frequency when the patient has diabetes for example, which results in thinning of the arteries and reduction in the amount of collaterals.

EECP performed on these patients before symptoms appear result in widening of coronary arteries, opening of small channels, formation of collaterals and prevention of atherosclerosis. Patients who have not yet developed CAD but have high risk factors of doing so, who have a family history of sudden death and heart attack at an early age also are fit to receive EECP. Patients who complain of angina but have a normal coronary angiogram or those who have drug-resistant hypertension can use EECP treatment for its vasodilating and diuretic effects.

What are the Beneficial Effects of EECP in Other Organs?
EECP increases blood flow to the organs. Diseases related to decreased perfusion can be treated this way. It is also used in ischemic diseases concerning especially the brain, eyes, ears and kidneys. Plus, aged men experiencing impotence due to erectile dysfunction certainly do benefit from it.

Due to increased perfusion in the brain, cognitive dysfunctions such as sleep deprivation, forgetfulness and inability to concentrate improve, as does the psychological status and a depressive mood. Positive psychosocial effects render the patients well and energetic.

Update Date: 5/28/2013 9:44:12 AM