It is all too common for chronic angina to fail to respond to traditional treatment methods. Enhanced external counterpulsation (EECP) offers an alternative treatment when the usual methods such as nitroglycerine appear to be failing. EECP works by stimulating blood vessels to literally branch out. This method encourages the development of small branches off the main vessels that serve to create a natural bypass that circumvents the clogged arteries than are the source of angina pain.
How EECP Operates
The beauty of EECP is in part that it may eliminate the need for an operation such as a cardiac bypass. The treatment exerts firm pressure on blood vessels located in the lower limbs. This serves to increase blood flow to the heart. The individual waves of pressure are synchronized electronically to the rhythms of the patient’s heartbeat. At the very moment the heart relaxes a wave of pressure delivers increased blood flow to the heart.
Pressure is released at the precise moment that the heart beats once more. This serves to lower the natural resistance that would be expected of the blood vessels in the leg. This, in turn, causes the blood to be pumped more easily from the heart.
The hope and expectation is that the smaller blood vessels found inside the heart would be encouraged to open. In time, these ancillary or collateral vessels may develop into a natural bypass that provides the necessary flow of blood to the heart itself.
EECP Treatment Described
EECP is not a traditional surgical procedure; it is a non-invasive outpatient therapy.
Three electrodes are placed on the skin of the chest while a patient lies supine on a padded table. The electrodes are hooked up to an electrocardiograph (ECG), which displays heart rhythm as the treatment progresses. Blood pressure is monitored as well.
Cuffs that somewhat resemble common blood pressure cuffs are wrapped around the patient’s buttocks, calves and thighs. The cuffs are inflated and deflated by a system of valves and hoses connected to the cuffs. Patients describe this treatment as resembling a powerful hug that migrates from calves to thighs to buttocks as the cuffs inflate sequentially. Pressure eases rapidly as the cuffs deflate. The waves of pressure are synchronized electronically to the rhythms of the patient’s heartbeat and blood pressure.
Frequency of Treatment
A typical treatment regime entails 35 at least total hours. Treatments are scheduled to occur 1 to 2 hours a day, five days a week, for 7 weeks.
Eligibility for Treatment
Patients exhibiting chronic stable angina, an inability to qualify for invasive procedures such as bypass, angioplasty, or stenting and whose angina is not responding to medications like nitrates, beta-blockers and calcium channel blockers are the optimal subjects for this procedure.
Treatment Results
Preliminary studies point to considerable benefits experienced by patients who undergo EECP. Those benefits include:
• Alleviation of angina symptoms
• Greater angina-free activities for stable angina patients
• Diminished requirement for anti-angina medications
• Increased capacity and enjoyment of everyday activity