Enhanced External Counterpulsation (EECP) is a non-invasive therapy that has been used for over 60 years to treat cardiovascular conditions such as angina, heart failure, and coronary artery disease. In this article, we will explore the history of EECP, its usage, benefits, and clinical research, as well as some case studies that illustrate its effectiveness.
History of EECP Treatment
The first EECP machine was developed in the 1950s by Dr. Paul M. Zoll, a cardiologist at Harvard Medical School. Zoll’s machine used a series of inflatable cuffs placed around the patient’s legs to create a counterpulsation effect that helped increase blood flow to the heart during systole. Over the years, improvements were made to the technology, and in the 1990s, EECP machines became widely available for clinical use.
Usage of EECP Treatment
EECP treatment is typically administered in a series of one-hour sessions, five days a week, for a total of 35 sessions. During each session, the patient lies on a table, and cuffs are placed around their calves, thighs, and buttocks. The cuffs inflate and deflate in sync with the patient’s heartbeat, creating a counterpulsation effect that helps increase blood flow to the heart.
Benefits of EECP Treatment
EECP treatment can provide several benefits for patients with certain cardiovascular conditions. Here are some of the potential benefits of EECP treatment:
- Increased blood flow to the heart: EECP treatment helps improve blood flow to the heart by creating a counterpulsation effect that helps pump blood back to the heart during systole.
- Improved circulation: EECP treatment can help improve circulation by opening up collateral blood vessels that may have been previously blocked.
- Reduced chest pain: EECP treatment has been shown to reduce chest pain in patients with angina.
- Lowered blood pressure: EECP treatment has been shown to lower blood pressure in patients with hypertension.
- Enhanced exercise tolerance: EECP treatment can help improve exercise tolerance in patients with heart failure by increasing blood flow to the heart and reducing shortness of breath.
- Reduced need for medication: EECP treatment can help reduce the need for medication in some patients with certain cardiovascular conditions.
- Improved quality of life: EECP treatment can improve quality of life by reducing symptoms such as chest pain, shortness of breath, and fatigue.
Clinical Research
Two-year outcomes in patients with mild refractory angina treated with enhanced external counterpulsation
Clin Cardiol. 2006 Feb;29(2):69-73. doi: 10.1002/clc.4960290207.
Abstract
Background: In the International Enhanced External Counterpulsation Patient Registry (IEPR), approximately 85% of the patients treated are in Canadian Cardiovascular Society (CCS) class III-IV with no option for further invasive coronary revascularization procedures.
Hypothesis: This study sought to determine whether it is clinically important to establish whether the observed durable reduction in disabling severe angina with enhanced external counterpulsation (EECP) treatment can be extended to those with less severe CCS class II angina, who also have no option for further revascularization.
Methods: This study evaluated the immediate response, durability and clinical events over a 2-year period after EECP treatment in 112 patients with Canadian Cardiovascular Society (CCS) class II angina versus 1,346 patients with class III-IV angina using data from the International EECP Patient Registry (IEPR).
Results: Treatment with EECP significantly (by at least one CCS class) reduced angina frequency, nitroglycerinuse, and improved quality of life in both groups. At 2-yearfollow-up, 74% of class II and 70% of class III-IV patients remained free of major adverse cardiovascular events (MACE) and continued to demonstrate a durable CCS class improvement over baseline.
Conclusion: The robust effectiveness of EECP as a noninvasive device, together with its relatively low start-up and recurrent costs, makes it an attractive consideration for treating patients with milder refractory angina in addition to the patient with severely disabling angina treated in current practice.
