EECP: An alternative to Bypass Surgery

Enhanced External counter pulsation (EECP) is a US-FDA-approved treatment for patients with heart blockages exertion. EECP uses three cuffs (similar to blood pressure cuffs) that are placed on the calves, legs and hip region which contract sequentially during the resting phase of the heart (diastole) of thecardiac cycle. EECP improves chest pain symptoms and exercise capacity and reduces dependency on chest pain (angina) medicines of the patient.EECP is also shown to be beneficial in patients suffering from congestive heart failure.

The EECP course is a 35-day,one hour daily, six days a week course. The course of the therapy can be extended for patients who do not develop an improvement in symptoms until late in the therapy. EECP is a safe, non-invasive treatment for patients with chronic stable angina with no requirement for hospitalisation and can be done on a day care basis.

The EECP treatment benefits heart patients by establishing collateral circulation. Collateral circulation is the formation of tiny blood vessels, which make it possible for blood to detour around blocked vessels or narrowed arteries. Development of collateral circulation is gradual and takes years in the normal course of action. EECP triggers and accelerates these collateral formations and makes it permanent for those who receive the complete treatment of 35 sessions.

The cuffs of the EECP machine are tied on the calves,legs and hip region of the patients. ECG electrodes are applied to the patient's chest,the cuffs applied sequentially pump during the resting phase of the heart. First the calves, then the thighs, and then the hips inflate during the resting phase of the heart. This increases the blood flow back to the heart and increases the blood supply to the coronary arteries, and also increases the blood pumped by the heart to the other organs of the body.

EECP treatment is safe and involves no risk during the procedure. After taking the entire course of the treatment, the patients can walk for longer distances, without chest pain and with less or no angina (chest pain) and reduced dependency on chest pain medicines. Overall, the patient will feel more energetic and his/her quality of life will improve. The benefits of EECP can last up to three to five years after completing the full course of 35 sessions. After the completion of the course, the patients should take their medications regularly and avoid smoking, alcohol intake and tobacco consumption. They should exercise regularly, watch their weight, control cholesterol and follow a heart-friendly diet to prevent progression of the disease and to maintain the effect of EECP.

This treatment is so safe and effective that even a healthy individual can take it to further enhance his/her heart condition,stamina and cardiovascular functionality. Once a patient undergoes this treatment huge improvement in their angina (chest) pain, diabetes, hypertensions, kidney function, post-stroke conditions, and in some cases, erectile dysfunction can be seen. Patients who have already undergone an angiography or bypass surgery can also take this treatment to improve their angina pain and avoid future surgeries. This is because unlike bypass surgery and angioplasty, EECP targets entire heart altogether and improves overall heart circulation.

In a multicentre study that EECP (MUST-EECP) conducted, in which 139 patients with chronic stable angina were randomly given a full course of EECP or control group with minimal pressure. The reports showed significant improvement in exercise capacity as compared to the control group. These results were maintained 12 months after EECP. Patients taking EECP showed a reduction in intensity and frequency in chest pain as compared to before taking the treatment.

In another study conducted, it showed that patients who have taken the EECP had averted major cardiovascular events as compared to the patients who had not taken the treatment. The overall five-year survival of EECP patients was 88 percent as compared to patients on medical management or revascularisation. There is an 83 percent reduction in hospitalisation rate as compared to six months before EECP.

The Prospective Evaluation of Enhanced External Counterpulsation in Congestive Heart Failure (PEECH) trial had done a study on 187 patients with stable symptomatic mild to moderate heart failure LVEF<35. The group of patients on EECP demonstrated significant improvement in exercise time as compared to the control group (patients who were not given EECP).

In a study conducted on 108 patients, EECP demonstrated a reduction in the systolic blood pressure at the end of the therapy.

EECP is used successfully for chest pain treatment and congestive heart failure showing an improved exercise capacity. Decreased chest pain and dependency on angina medicines and improved myocardial perfusion.

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