EECP Overview
EECP Definition
EECP is a noninvasive treatment for patients with coronary artery disease. Clinical studies over the past several years have shown that about 75-80% of patients treated with single course of EECP experience a reduction in angina and are able to return to a more active lifestyle.
EECP involves the inflation and deflation of 3 sets of compressive cuffs wrapped around the patient’s calves, lower thighs and upper thighs including the buttocks.
During diastole, the cuffs are inflated sequentially from the claves to the upper thighs and buttocks to raise diastolic aortic pressure. Compression of the vascular beds of the legs also increases venous return.
Rapid and simultaneous deflation of the cuffs at the onset of systole produces left ventricular unloading with an associated decrease in cardiac workload. Inflation and deflation are triggered by events in the cardiac cycle via microprocessor interpreted ECG signals.
Treatment Regimen
Patients are usually treated with EECP one hour a day, six days a week for six weeks for a total of 35 hours.
Patients receiving EECP: cuffs inflated sequentially from the calves to the upper thighs and buttocks to raise diastolic coronary perfusion pressure and increase venous return. Cuffs deflate at the onset of systole producing left ventricular unloading with an associated decrease to cardiac workload.
Hemodynamic Effects
The acute hemodynamic effects of external counter pulsation are similar to those seen with an intra-aortic balloon pump with the addition of increase venous return.
- Increased diastolic perfusion pressure.
- Increased coronary perfusion.
- Increased coronary flow to ischemic regions of the myo-cardium.
- Decreased left ventricular workload and oxygen consumption
- Reduce systemic vascular resistance
- Decrease left ventricular end diastolic pressure (LVEDP)
- Increased venous return
As a result, stroke volume per unit work and therefore, efficiency of the left ventricle increase. Cardiac output is raised by as much as 60%.