When Enhanced External Counter Pulsation (EECP) is Right for Angina

For some heart failure patients, a treatment known as EECP is a beneficial alternate solution, but it requires a commitment.

5 min readMar 18, 2021

When a heart patient suffering from angina doesn’t qualify for surgery or coronary stenting and also qualified for surgery, Now doctor recommend enhanced external counter pulsation (EECP), a noninvasive treatment designed to help lower the number and intensity of angina episodes and risk of heart failure.

EECP therapy involves three external inflatable cuffs applied around the lower legs, upper legs and buttocks. The cuffs alternately inflate when the heart is on resting mode and deflate during the pumping period of the heartbeat.

Eligible patients are those who have considered too had coronary artery bypass or stents placed in the coronary arteries with ongoing angina or those who are not candidates for bypass or stents but continue to suffer from angina episodes. These patients must have undergone all other possible medical therapies to be measured eligible for this treatment.

George Forbes is one of such patients. His heart story began in 1998 when he got a heart attack and was taken by ambulance to the University of Michigan, where doctors performed emergency quadruple bypass surgery urgently. Forbes, then 43, recovered quickly and got back to living an active life.

But 1 year ago, at age 62, three of Forbes’ four bypasses misshapen, leaving him in heart failure.

Because of his health situation, Forbes’ heart team decided not to do any surgery — including U-M Frankel Cardiovascular Center cardiologists Francis Pagani, M.D., Melvyn Rubenfire, M.D., and Monica Colvin, M.D. — declared he was not a right candidate for heart surgery.

Their recommendation: EECP Therapy,

The therapy could have dramatic effects when applied over multiple visits.

EECP process improves the blood flow to all organs and, most important, over time it increases the health of all the coronary arteries, Rubenfire said. “By Improving the health of blocked arteries increases the blood flow of heart while at rest, and, with exercise, that would normally have triggered chest pain and shortness of breath.

“The great no of heart patient has more energy and could exercise with much less angina or heart pain,” Rubenfire adds. “For some, the effects of EECP treatment can last up to two years depends on patients life style .”

Making the commitment

Although EECP therapy do the work, they’re useless without a willing recipient.

“Dr. Rubenfire said to me that EECP therapy process would take a big commitment on my part,” Forbes recalls. “EECP required me to go for treatment Monday through Friday for one hour every day for seven weeks.” Also on the schedule: thrice-weekly cardiac rehab and done my all-day routine normally.

Such responsibility is what keeps many patients from participating in EECP, says U-M cardiologist Michael Shea, M.D., noting that many patients are reluctant or unable to put in the effort.

The course of action also can be costly.

Still, “EECP treatment is sheltered by most insurance providers,” says U-M exercise physiologist Aaron Tice, but he indorses patients check with their insurance company to make sure all sessions are shielded, noticing that the cost per treatment is approximately $280.

Forbes, on disability due to his severe condition, felt the time commitment the most for treatment — only a short travel from his home — was a small price to pay if it helped eradicate his angina.

“In advance of the program, I had stopped outing and going out of the house every day,” says Forbes. “Now I feel more confident and stable.”

With his EECP treatment therapy and cardiac rehab completed, Forbes said that he exercises on a regular basis and gets out often in mornings. He now some time experiences only mild angina very rarely and has improved blood pressure normally. He says EECP was a great alternative solution.

Curtesy:

University of Michigan, call Aaron Tice at 734–998–5676.

How Effective Is EECP?

Several studies propose that EECP can be quite effective in treating chronic stable angina.

A casual trial displayed that EECP pointedly improved both the symptoms of angina (a subjective measurement) and exercise tolerance a more objective measurement in people with CAD. EECP also significantly improved quality-of-life measures compared to placebo therapy.

Why Isn’t EECP Used More Often?

The cardiology community has chiefly chosen to ignore such an unconventional form of therapy, and many cardiologists fail to even consider offering EECP as a therapeutic option. Subsequently, most people with angina episodes never hear about it.

That’s unlucky, as it doesn’t seem unreasonable to allow patients with stable angina to option for a trial of a noninvasive therapy, maybe even before they are pushed into invasive therapy, when:

A noninvasive treatment exists
It’s safe and well-tolerated
It’s supported by available indication (albeit imperfect) that strongly suggests the treatment is quite effective in many
Those being treated can tell you pretty ultimately whether it substantially reduces angina symptoms frequently.

If anyone being preserved for stable angina and still have symptoms despite therapy, it’s entirely reasonable for you to bring up the possibility of trying EECP. Your doctor should be prepared to discuss this possibility with you, objectively and without prejudice.