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EECP Treatment -- Should I Have It?

Certain Medical Conditions Rule Out This Angina and Heart Failure Treatment

By Nancy Larson

Updated December 15, 2008

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(LifeWire) - Enhanced external counterpulsation (EECP) treatment brings long-term relief to 80% of angina patients treated with it. There is inconclusive evidence it may help heart failure patients, too. But EECP is not for everyone.

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
  • Pregnancy
Before every treatment, doctors recheck patients' weight, blood pressure, heart rate and oxygen level, and fluids in the lungs and legs. The patients' vital signs are also monitored during the procedure.

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.

Read more about EECP here.


"Enhanced External Counterpulsation (EECP) ." dukeheartcenter.org. 22 Feb. 2005. Duke Heart Center. 4 Dec. 2008 <http://dukeheartcenter.org/handler.cfm?event=practice,template&cpid=8764>. 

"Enhanced External Counter Pulsation (EECP) in the Heart and Vascular Program at El Camino Hospital." elcaminohospital.org. 2005. El Camino Hospital. 4 Dec. 2008 <http://www.elcaminohospital.org/documents/Brochures/EECP_Brochure.pdf>. 

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/>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Nancy Larson is a St. Louis-based freelance writer whose work has appeared in dozens of local and national print and online publications including CNN.com, The Weather Channel, Health magazine and The Advocate.

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