EECP Therapy.
A non-surgical approach to better heart health.
Enhanced External Counterpulsation: a non-invasive, outpatient treatment designed to improve blood circulation to the heart and reduce symptoms of angina, now available at Rattan Multispecialty Hospital, Jalandhar.
35
Sessions in a conventional course
1 hr
Each session
≈ 7 wks
Typical course duration
0
Incisions, catheters or stents
What is EECP therapy?
Enhanced External Counterpulsation (EECP) is a non-invasive, outpatient treatment designed to improve blood circulation to the heart, reduce symptoms of angina (heart-related chest discomfort), and help selected patients with coronary artery disease.
EECP offers an additional treatment option for people who continue to experience chest pain, breathlessness or limitations in daily activities despite receiving appropriate medical treatment.
Unlike angioplasty or bypass surgery, EECP does not require incisions, catheters, stents or general anaesthesia.
It is particularly useful for selected patients who:
- Have persistent angina despite medicines
- Have undergone angioplasty or bypass surgery but continue to experience symptoms
- Are not suitable candidates for further procedures
Important: EECP is not a replacement for emergency cardiac treatment, essential medications, angioplasty or bypass surgery when these are medically indicated.
How does EECP work?
EECP works by using specially designed inflatable cuffs wrapped around the calves, thighs and buttocks. These cuffs inflate and deflate in precise coordination with the patient's heartbeat, using ECG monitoring.
Step 1
Increased blood flow to the heart
During the relaxation phase of the heartbeat (diastole), the cuffs inflate sequentially, helping push blood back towards the heart and increasing pressure in the coronary circulation.
Step 2
Reduced workload on the heart
Just before the heart contracts, the cuffs rapidly deflate. This reduces resistance against which the heart pumps, potentially decreasing its workload.
Step 3
Improved circulation over time
Repeated sessions may improve vascular function and the body's ability to deliver blood to heart muscle. Some patients experience fewer angina episodes and improved exercise tolerance.
Major benefits of EECP therapy
Non-surgical treatment
No cuts, stitches, catheter insertion or implanted devices.
No routine hospital admission
Generally performed as an outpatient procedure.
Relief from angina
Can reduce the frequency and severity of chest discomfort in selected patients.
Better physical activity
Some patients can walk farther and perform daily activities with fewer symptoms.
Improved quality of life
Reduced symptom burden may help patients return to more comfortable daily routines.
Support after previous cardiac procedures
May benefit patients with persistent or recurring angina after stenting or bypass surgery.
Potential reduction in angina medication needs
Some patients may require fewer anti-anginal medicines after reassessment by their cardiologist; medicines must never be stopped independently.
A conventional course
35
one-hour sessions
≈ 7
weeks
Your cardiologist
decides the plan
A conventional EECP course commonly consists of 35 one-hour sessions over approximately seven weeks, although the treating cardiologist determines the appropriate plan.
Is EECP safe and recommended?
EECP is a well-established, non-invasive treatment option for carefully selected patients with chronic refractory angina: chest discomfort that continues despite appropriate medical treatment, particularly when further revascularisation is unsuitable.
It is generally well tolerated, and patients remain awake throughout treatment.
Common side effects
- Temporary leg discomfort
- Skin irritation
- Bruising
- Fatigue
May make treatment inappropriate
- Significant aortic regurgitation
- Certain uncontrolled arrhythmias
- Active blood clots
- Severe peripheral vascular disease
- Decompensated heart failure
However, EECP is not risk-free and is not recommended for every heart patient. Cardiology assessment is essential before starting therapy.
EECP Therapy for Patients with Low Heart Pumping (Low Ejection Fraction)
Understanding low heart pumping
The heart's pumping efficiency is commonly measured through the Left Ventricular Ejection Fraction (LVEF).
A healthy heart generally has an ejection fraction of approximately 55–70%. When pumping efficiency falls, patients may experience breathlessness, fatigue, reduced stamina and swelling in the legs.
How can EECP help patients with low pumping?
For selected, clinically stable patients with reduced heart pumping function, EECP may offer potential benefits.
Reducing the heart's workload
By rapidly deflating the cuffs before each heartbeat, EECP can temporarily reduce the resistance against which the heart pumps.
Supporting coronary blood circulation
The treatment increases coronary perfusion pressure during the relaxation phase of the heartbeat, which may help deliver blood to heart muscle.
Improving exercise tolerance
Some studies suggest improvements in exercise capacity and symptoms in selected patients with stable heart failure.
Supporting daily activity
Patients may experience improved stamina and less discomfort during routine activities, particularly when angina contributes to their limitations.
Can EECP help after a stent or bypass?
Can patients with stents undergo EECP?
Yes. Having a coronary stent does not automatically prevent a patient from receiving EECP.
Angioplasty and stent placement are performed to restore blood flow through narrowed or blocked coronary arteries. However, some patients continue to experience chest discomfort or develop recurrent angina after the stents.
EECP may be considered for such patients when their symptoms persist despite appropriate medical treatment and further coronary intervention is not suitable.
Potential benefits after stenting
- May reduce persistent or recurring angina.
- May improve exercise tolerance.
- May support blood circulation in the coronary vascular system.
- May improve quality of life in selected patients.
- Provides a non-invasive option when additional intervention is unsuitable.
Who may benefit from EECP?
EECP evaluation may be appropriate for patients with:
- Chronic stable angina despite medicines
- Persistent angina after coronary stenting
- Recurrent angina after bypass surgery
- Coronary artery disease where additional angioplasty or surgery is unsuitable
- Reduced exercise tolerance associated with chronic myocardial ischaemia
- Stable reduced heart function with accompanying refractory angina, after careful specialist assessment
What do international cardiology guidelines say?
The 2023 American Heart Association/American College of Cardiology multisociety guideline states that EECP may be considered for symptom relief in patients with chronic coronary disease, refractory angina and no other treatment options.
This is a Class IIb recommendation, meaning that EECP may be useful for selected patients, but the supporting evidence is limited.
It is not a routine recommendation for every patient with coronary artery disease.
Frequently asked questions
Is EECP painful?
EECP is generally well tolerated, and patients remain awake throughout treatment. Common side effects include temporary leg discomfort, skin irritation, bruising or fatigue.
Does EECP require hospitalisation?
Generally, no. It is an outpatient procedure, and most patients return home after each session.
Is EECP a permanent cure for coronary artery disease?
No. EECP may relieve symptoms, but it does not cure atherosclerosis or eliminate the need for ongoing cardiac care.
Can patients stop their heart medicines after EECP?
No medicines should be discontinued without their cardiologist's advice. Antiplatelets, cholesterol-lowering drugs and heart failure medicines remain important when prescribed.
Is EECP safe for elderly patients?
Age alone does not determine suitability. The patient's cardiovascular condition, blood vessels, rhythm, blood pressure and overall health must be assessed.
Does EECP prevent heart attacks?
There is insufficient evidence that EECP prevents heart attacks or improves survival. Its established clinical role is primarily symptom relief in selected patients with refractory angina.
A non-surgical option for selected heart patients
At Rattan Multispecialty Hospital, we believe that patients with persistent heart-related symptoms deserve a thorough evaluation of all appropriate treatment options.
Under the guidance of Dr. Balraj Gupta and the medical team, patients can be assessed for suitable cardiac treatment and ongoing management.
EECP may provide an additional approach to symptom management for selected patients living with chronic coronary artery disease, including those who continue to experience angina after angioplasty or bypass surgery. Our focus is on individualised medical assessment, patient safety, appropriate treatment selection and improved quality of life.
Is EECP suitable for you?
Consult our medical team to find out whether EECP is suitable for your heart condition.
Rattan Multispecialty Hospital
280, Shaheed Udham Singh Nagar, Jalandhar
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