Search
enhanced external counterpulsation (EECP)
Indications:
- refractory angina when revascularization is not an option
Procedure:
A series of inflatable cuffs is applied to the lower extremities & gated to the electrocardiogram to provide increased diastolic flow to the coronary arteries & afterload reduction during systole.
A series of daily treatments is given for 4-6 weeks.
Mechanism of action: unknown.
Notes:
- little to no benefit at 6 months follow-up [2]
- improvement in angina symptoms & exercise capacity can persist for up to 2 years [3]
- does not decrease mortality
General
counterpulsation
References
- Journal Watch 23(14):110, 2003
Bonetti PO et al
Enhanced external counterpulsation for ischemic heart disease:
what's behind the curtain?
Am J Coll Cardiol 41:1918, 2003
PMID: 12798558
- Feldman AM, Silver MA, Francis GS, Abbottsmith CW, Fleishman BL,
Soran O, de Lame PA, Varricchione T; PEECH Investigators.
Enhanced external counterpulsation improves exercise tolerance
in patients with chronic heart failure.
J Am Coll Cardiol. 2006 Sep 19;48(6):1198-205. Epub 2006 Aug 28.
PMID: 16979005
- Gottlieb SS, Pina IL.
Enhanced external counterpulsation: what can we learn from the
treatment of neurasthenia?
J Am Coll Cardiol. 2006 Sep 19;48(6):1206-7. Epub 2006 Aug 28.
PMID: 16979006
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16.
American College of Physicians, Philadelphia 2009, 2012