EECP -- approved for use in the 1990s -- increases the delivery of oxygen-rich blood to the heart, thereby lessening its workload. Over time, the use of EECP can even build tiny bypasses around blocked arteries.
In this nonsurgical, outpatient procedure, "air cuffs" are placed on each leg and they are inflated and deflated between heartbeats during 1- to 2-hour treatments every weekday for a 7-week duration.
EECP treatment is ideal for:
- Patients whose ongoing stable angina hasn't responded well to medication
- People who should not have surgery
- Patients whose conditions were not relieved by bypass surgery and angioplasty (procedures to widen blocked arteries by using a tiny balloon)
But one or more of these medical conditions usually rule out using EECP therapy:
- Severe or uncontrolled heart failure
- Blood pressure higher than 180/110 mmHg
- Heart rate of more than 120 beats a minute
- Extreme arrhythmia (irregular heartbeat)
- Pulmonary (lung) disease
- Phlebitis (inflamed veins)
- Severely diseased aortic valves
Possible complications include mild headache or dizziness, fatigue or aching muscles. Rarely, EECP may increase heart rate, cause an irregular heartbeat, or overwhelm heart failure patients, which can cause their heart condition to worsen. Patients with diabetes may sometimes suffer skin irritation or ulcers as a result of the repeated daily pressure delivered by the leg cuffs.
Most patients require no recovery period. Some report feeling better after only 10 sessions. After the full course of treatment, almost all say they also enjoy improved endurance and a better quality of life.
Private insurance companies and Medicare usually cover EECP treatments for angina, but not for heart failure.
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Manchanda, Aarush, and Ozlem Soran. "Enhanced External Counterpulsation and Future Directions." Journal of the American College of Cardiology 50(2007):1523-31. 4 Dec. 2008 <http://content.onlinejacc.org/cgi/content/full/50/16/1523>.
"Reimbursement." stjohn.org. 2008. St. John Health. 4 Dec. 2008 <http://www.stjohn.org/EECP/physicians/reimbursement/>.