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Enhanced External Counterpulsation (EECP)

There are a large, increasing number of patients who have persistent anginal symptoms, who have exhausted the standard treatments for revascularization and remain severely restricted. Enhanced External Counterpulsation (EECP) may stimulate the openings or formation of collaterals (small branches of blood vessels) to create a natural bypass around narrowed or blocked arteries.

Who is a candidate for EECP?

You may be a candidate if you:

  • Have chronic stable angina
  • Are not receiving adequate relief from angina by taking nitrates
  • Do not qualify as a candidate for invasive procedures (bypass surgery, angioplasty, or stenting)

What happens during EECP treatment?

EECP is a non-invasive, outpatient therapy. During treatment:

  • Patients lie down on a padded table in a treatment room
  • Three electrodes are applied to the skin of the chest and connected to an electrocardiograph (ECG) machine. The ECG will display the heart’s rhythm during treatment. Blood pressure is also monitored.
  • A set of cuffs is wrapped around the calves, thighs and buttocks. These cuffs attach to air hoses that connect to valves that inflate and deflate the cuffs. Patients experience a sensation of a strong "hug" moving upward from calves to thighs to buttocks during inflation followed by the rapid release of pressure on deflation. Inflation and deflation are electronically synchronized with the heartbeat and blood pressure using the ECG and blood pressure monitors.

How does EECP work?

  • The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to your heart. Each wave of pressure is electronically timed to the heartbeat, so that the increased blood flow is delivered to your heart at the precise moment it is relaxing. When the heart pumps again, pressure is released instantaneously. This lowers resistance in the blood vessels in the legs so that blood may be pumped more easily from your heart.
  • EECP may encourage blood vessels to open small channels that become extra branches. These channels or collaterals may eventually become "natural bypass" vessels to provide blood flow to heart muscle. This contributes to the relief of angina symptoms.

How often are patients treated?

Patients who are accepted for treatment must undergo 35 hours of EECP therapy. Treatment is administered 1-2 hours a day, five days a week, for 7 weeks.

Published studies conducted at numerous medical centers have demonstrated benefits for most patients including:

  • Less need for anti-anginal medication
  • Decrease in symptoms of angina
  • Increased ability to do activities without onset of symptoms
  • Ability to return to enjoyable activities

Resources

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Reviewed: 01/10

Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2014 Cleveland Clinic. All rights reserved.

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