ECP / EECP - INTRODUCTION

External Counter Pulsation (ECP or EECP) Therapy is a safe, non-invasive therapy that has remarkable clinical benefits to the appropriate patients.

ECP / EECP is approved by USFDA to treat the following INDICATIONS:
FDA approved and Medicare insurance covered indications:.

• • Stable angina pectoris and unstable angina pectoris
• • Myocardial infarction
• • Cardiogenic shock
• • Cardiac syndrome x
• • Congestive heart failure

Several international health authorities like NHS, USFDA, Health Canada, UK’s MHRA, TGA, MCC (SA) etc. has recognized ECP/ EECP as an effective tool to treat Ischemic Heart Disease.

ECP/ EECP therapy is an incredibly effective treatment continuing to gain momentum for patient care around the world. Within the ever-changing landscape of the international healthcare industry. More and more physicians has started considering ECP/ EECP as a viable treatment option for their practice because of the great clinical and financial rewards.

ECP / EECP is a non- invasive cardiac treatment procedure that is FDA approved to treat patients with stable and unstable angina, myocardial infarction, cardiogenic shock and congestive heart failure, ECP / EECP treatments are widely recognized and approved by cardiology societies around the world as it produces significant and long lasting results.

ECP / EECP is a clinically proven, safe, economical and effective outpatient treatment procedure. Here, the patient lays on a treatment table with pneumatic cuffs (like cuffs used in blood pressure apparatus) on their calves, thighs and buttocks. During diastole blood is squeezed from lower extremities starting at calves, then thighs and then buttocks in a sequential method. This ultimately results in delivering high volume of blood into the coronary arteries. This is called inflation (augmentation). Then before the start of next cardiac cycle (systole), the cuffs deflate simultaneously thus reducing after load, which circulates the blood back form heart to the other parts of the body.

This reduces the work load of the heart in pumping adequate blood supply throughout the body and hence improving LV function. The increase in flow & pressure of the blood forced into the vessels over time creates more collateral channels and thus naturally bypasses around narrowed or blocked arteries (angiogenesis) and it also recruits dormant vessels. This therapy reduces symptoms and increases exercise tolerance through increased perfusion.

To make it simple, ECP/ EECP creates acute hemodynamic change in both flow and pressure during diastole and increases perfusion not only in areas of the heart receives less than adequate blood supply, but also to each and every vital parts of the body like brain, renal, peripheral artery etc.

ECP/ EECP therapy is typically provided in 35, one-hour treatment sessions over a period of approximately seven weeks. Additional hours may safely and effectively be prescribed to this regimen if physician evaluation of the patient’s response to treatment determines additional hours will result in greater relief of symptoms. In certain circumstances, adjusting the patient’s treatment regimen to two hours per day can make it more comfortable for the patient to complete a course of ECP/ EECP therapy sooner.

The counter pulsating action of ECP / EECP therapy increases venous return and cardiac output. During ECP/ EECP therapy systolic unloading is improved by increasing blood flow and oxygen to the heart, while diastolic augmentation increases the energy supply to the heart thus reducing the after load of the heart. The hemodynamic effects of ECP/ EECP also increase the pressure gradient as well as the release of vascular growth factors that enhance coronary collateral circulation. The increase of blood flow increases shear stress on the walls of the arteries and improves endothelial function. Studies have shown that the hemodynamic of ECP/ EECP therapy closely resemble those of the intra-aortic balloon pump (IABP) long held as the “gold standard” for circulatory support of hemodynamically compromised patients. The magnitude of diastolic augmentation that can be achieved with ECP/ EECP therapy was found comparable to that of the IABP.

ECP RESULTS IN: Increased venous return Increased preload / Stretch  Increased Cardiac Output Retrograde arterial flow Increased diastolic pressure with increased intracoronary perfusion Increased vascular recoil and systolic unloading Decreased systemic vascular resistance Decreased afterload Decreased myocardial oxygen consumption

MECHANISM OF ACTION: